Tue | Nov 19, 2019

Dear Doc | Will a Pap smear hurt my pregnancy?

Published:Sunday | April 14, 2019 | 12:06 AM

Q Dear Doc, there has been a lot of talk recently about Pap smear. Well, I never had one and I went to make my appointment for my first pregnancy visit. The nurse told me that when the doctor sees me, they will want to do one. Is that safe? Will it harm my pregnancy? What will be done? Do I have to do it? If I do it and it is abnormal, will I be able to continue with the pregnancy? I need your help before I have the doctor visit.

A Most doctors will recommend getting a Pap smear in early pregnancy as a part of routine prenatal care. It usually takes just a few minutes. The test checks for abnormal cells on the cervix, which is a part of the uterus commonly called the neck of the womb. The presence of abnormal cells could mean the presence of cervical cancer. If a Pap test does show that you have abnormal cervical cells, then your doctor might perform a second test called a colposcopy, which will allow your doctor to look at your cervix more closely and better make that diagnosis.

It is always a good idea to get regular Pap smears done when you are not pregnant. It is recommended that you get your first Pap smear at age 21, or two years after first having sexual intercourse, if that occurs after age 21. You should then get one every two years until age 65. Your physician will tell you what the ideal frequency is for you.

WHAT HAPPENS DURING A PAP TEST?

For a Pap smear to be performed, you will be asked to undress from the waist down, and to lie on your back on the examination bed. You will be asked to put your feet into stirrups. The doctor will use a medical instrument called a speculum, along with lubricant jelly, to examine the cervix and then use a small brush or spatula to swab a sample of cells from the cervix for testing. The procedure is short and not painful. Some women feel nothing, while most feel mild discomfort during this exam. The more that you relax your body and vaginal muscles, the more comfortable the Pap smear procedure will be.

CAN A PAP SMEAR CAUSE A MISCARRIAGE?

Some women may experience light vaginal spotting after the test, due to the sensitivity of the cervix during pregnancy, but it’s not likely that a Pap smear would cause a miscarriage. This is because the growing foetus is implanted higher up in the uterus and not near the cervix. Even in the event that the foetus is implanted lower in the uterus and closer to the cervix, the cervix is quite thick in the first trimester, so the light scraping from a Pap test would not disturb the pregnancy.

Nevertheless, if you are worried about getting a Pap test during early pregnancy, discuss your concerns with your doctor. It is possible that your doctor may agree to postpone the Pap test until your postpartum check-up, especially if you are not yet 21 and within two years of your first sexual intercourse.

If your Pap smear results are abnormal, it does not mean you have cancer. There are different kinds of abnormal results, and depending on the results, you may either need no treatment, another Pap smear screening test one year after your abnormal test, or a colposcopy may be required. This procedure is also safe to be performed during your pregnancy. However, further treatment will probably be delayed until after your baby is born.

Having an abnormal Pap smear does not pose a risk to your baby or your pregnancy, so in the event that it is, you will be able to continue with your pregnancy.

You should still, however, express your concerns to your doctor so that they can be addressed and determined if it can wait until after your delivery.

deardoc@gleanerjm.com