Τρίτη 30 Αυγούστου 2016

Screening for cervical cancer during pregnancy

2016-08-30T00-35-53Z
Source: International Journal of Community Medicine and Public Health
Banumathy Manikkam.
Background: Carcinoma cervix is the second most common gynaecological cancer causing deaths among women. PAP smear being most sensitive and specific screening test reducing mortality and morbidity, can be used to identify early changes in cervix during pregnancy. The aim of the study was to offer cervical cancer screening for pregnant women and motivate them into the mainstream of screening subsequently and evaluate their acceptance. Also to identify reproductive tract infections, associated pregnancy changes and their effect on pregnancy outcome. This prospective study enrolled 200 normal pregnant patients admitted at Sri Rama Krishna Hospital from September 2012 to January 2014. Methods: All the patients selected for this study underwent history taking and examination .Pap smear was taken with patient in dorsal position. Among 200 cases, 196 (98%) were adequate smears and only 4 (2%) were inadequate. Adequate smears which were grouped as per Bethesda system, majority (97.5%) fell in Group I and were found to be normal or inflammatory smear, while only one showed ASCUS. Of the cases in Group I, 114 cases (57%) showed inflammation while 81 cases (40.5%) were normal. Statistical analysis used was SPSS 11.5. Results: Majority of the patients involved in study were in the age group of 20-35years with only 3.5% below 19yrs and 2% above 35years with mean age of 26.9years. Most of the patients were married at 20-30yrs of age while only 4.5% were married after 30 with mean age of marriage 23.4yrs. Importantly 15% had an early marriage between 15-19yrs. Most of patients who consented for study belonged to third trimester (91.5%) followed second trimester (17%) with average of 32.7wks. About 80% had knowledge regarding screening for cervical cancer. Statistical analysis used was SPSS 11.5. Conclusions: PAP smear being a cost effective, easy to perform test, can be carried out even in pregnant woman. It does not interfere with the natural course of pregnancy and hence safety is ensured. Pregnancy is a potential opportunity to counsel and educate them regarding the significance of screening.


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