Prevalence of Abnormal Pap Smear Among Pregnant Women, Postpartum Follow Upand Its Association With Sociodemographic Factors at Tertiary Care Centre: A Prospective Observational Study

Background: Cervical cancer is the most common genital malignancy diagnosed during pregnancy. Pregnancy and postpartum follow up provides an opportunity for a woman of a reproductive age to implement cervical screening in patients of a young age. Aim: 1) To estimate the prevalence of abnormal cervical cytology in pregnancy and postpartum. 2) To study the effect of sociodemographic factors on pap smear in pregnancy. Material & Methods: The study was conducted in OPD of obstetrics & gynaecology in GSVM medical college, Kanpur. Antenatal women between 21-45 years age from 10 to 34 weeks period of gestation were included in study. Patients with abnormal cervical cytology in pregnancy were followed in postpartum. Results: 6.3%(n=32) of antenatal patients had abnormal cervical cytology where ASCUS is 2.0%(n=10), LSIL is 3.3%(n=17), HSIL is 1.0%(n= 5) and SCC is 0.0%(n=0). 93.7% (n= 478) of pap smear findings reported to be as negative for intraepithelial malignancy (NILM). 43.5% subjects had non precancerous lesions such as vaginitis(12.5%, n=64), cervicitis(3.9%, n=20), bacterial vaginosis(1.4%, n= 7), reactive cellular changes (1.6%, n= 8), pregnancy associated changes(23.9%, n=122) and vaginitis with leptothrix (0.2%, n=1). Around 47%(n=15) regression, 34%(n=11) persistence and 6.2%(n=2) progression of preinvasive cervical lesion was seen in postpartum period. Conclusion: Abnormal cervical cytology was mainly seen in pregnant women between 21-30 years and during second trimester in women with lower education and high parity. Pap smear is a reliable screening test and should be included in antenatal routine investigations due to high mortality rate in India. Most of the lesions regress in postpartum period.