A Pap smear is a screening test that examines cervical cells to detect changes indicating cervical cancer or precancerous conditions. During pregnancy, this routine prenatal screening is generally considered safe. It helps healthcare providers monitor cervical health for early detection and management of any potential cellular abnormalities.
Is It Safe and Why It’s Done
Pap smears are generally safe and pose no risk to the developing fetus. Healthcare providers often recommend this screening early in pregnancy as part of the initial prenatal assessment. Its primary purpose is to identify abnormal cervical cell changes, such as dysplasia, or to screen for cervical cancer. Early detection of these changes is important for effective management, even during pregnancy.
The cervix undergoes physiological changes during pregnancy, including increased blood flow, making it more sensitive. This heightened vascularity means minor spotting or light bleeding after a Pap smear is common and is typically harmless. The bleeding originates from the outside of the cervix and does not affect the uterus where the baby is developing. The cells collected are from the superficial layer of the cervix, ensuring the process does not disturb the pregnancy.
What to Expect During the Procedure
The Pap smear procedure during pregnancy is similar to that performed when not pregnant. You will lie on your back with your feet in stirrups, and a speculum will be gently inserted into the vagina to allow the healthcare provider to visualize the cervix. Providers may use a smaller speculum or a more gentle technique due to the cervix’s increased sensitivity during pregnancy.
During the test, a small spatula, brush, or swab is used to collect cells from the surface of the cervix. You may experience sensations of pressure or mild discomfort, but it is not typically painful. Light spotting or a small amount of bleeding is normal for one to two days afterward, due to the cervix’s increased blood supply. The collected sample is then sent for laboratory analysis.
What Happens if Results Are Abnormal
If a Pap smear during pregnancy yields abnormal results, it does not automatically mean cancer is present. Often, these results indicate minor cellular changes that can sometimes resolve on their own. The next step typically involves further evaluation, such as a colposcopy, which is a visual examination of the cervix using a magnifying instrument. Colposcopy is considered safe during pregnancy.
If a biopsy is needed during a colposcopy, it is usually performed cautiously, as there can be slight bleeding from the external part of the cervix. However, invasive procedures or extensive treatments, such as a loop electrosurgical excision procedure (LEEP), are generally deferred until after delivery to minimize potential risk to the pregnancy. Close monitoring of abnormal cells through repeat colposcopies is the typical approach throughout pregnancy, with treatment usually scheduled postpartum.