Question : Is it necessary and safe to perform PAP smear in pregnancy ?

Dr. Akselrod : PAP smear is recommended for all women age 21 or 3 years after beginning of sexual activity, whatever comes first. PAP smear is a screening test that is used to detect precancerous lesions or cancer of the cervix. If you are due for this test it should be done during pregnancy, usually during first prenatal visit. It is considered safe in pregnancy.

Question : I was called to come back because my PAP smear came back ABNORMAL. What does that mean ?

Dr. Akselrod : Abnormal PAP smear is one of the most common causes for which pregnant patients are being recalled by physician. First, take a deep breath and don’t worry yet. Abnormal PAP could mean many things, but most of the time it does not mean cancer. Here are some of the reasons why your PAP smear can be called abnormal:
• Infections
• Not enough cells were collected
• Abnormal cells visualized (most commonly result of Human Papilloma Virus)
• Cancer

Question : Will I need any treatment if my PAP smear is abnormal?

Dr. Akserlod : It depends on what your PAP smear showed. If it indicated infection you may need medications. If PAP smear detected abnormal cells – DYSPLASIA, you will either need to repeat PAP smear and/or have a Colposcopy.

Question : What is Colposcopy and is it dangerous to my pregnancy?

Dr. Akselrod : Colposcopy is a test during which your doctor will look through a special microscope at your cervix to see if there are any significant abnormalities. Colposcopy is not dangerous during pregnancy. Most of the abnormalities do not require immediate treatment and can be followed after delivery.

However, if significant abnormalities are noted your doctor may advise you to get a cervical biopsy or to obtain a second opinion with a specialist. Biopsy of the cervix during pregnancy may be associated with bleeding. They will only be necessary to exclude cervical cancer. Again, this is very rare.

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