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Pregnancy does not exempt a woman from screening examinations. This includes the cytological examination, which is recommended and must be performed on every expectant mother. When is the best time for a cytological examination and how should the results be interpreted?
Cytological examination in pregnancy – when should it be done?
Cervical cancer is the second most commonly detected cancer in pregnant women and in the postpartum period after breast cancer. Accordingly, any pregnant woman who has not had a cytological examination in the six months prior to pregnancy should have this examination at her first visit to the gynaecologist in pregnancy. In most cases, this happens in the 10th week of pregnancy. If for some reason the test is not carried out, it can of course be made up for in the following weeks of pregnancy. Many gynaecologists perform a cytological examination on their pregnant patients, regardless of how much time has passed since the last examination.
Cytological examinations in pregnancy – Result
The result of the cytological examination is determined on the basis of the Bethesda system and should be interpreted by a gynaecologist. A normal cytological result is called NILM (according to the former Papanicolau system group I and II). Abnormal results are: LSIL, ASC-US, HSIL, ASC-H, AGC.
In the case of an LSIL or ASC-US result, follow-up cytology is recommended 6 months after birth. In case of an HSIL, ASC-H or AGC result, immediate colposcopy is required, followed by colposcopy and cytology test every 12 weeks during pregnancy and every 6 weeks after delivery. Screening is mainly done between weeks 14 and 20 after consultation with a gynaecological specialist if invasive cervical cancer is suspected. The good news is that most lesions detected regress in the postpartum period. In contrast, invasive cervical surgery is avoided during pregnancy.
Cytological examinations in pregnancy – traditional or liquid?
In recent years, the advantages of liquid cytology LBC over traditional slide cytology have been increasingly pointed out in the professional world. This is due to the fact that liquid cytology can also be used to perform HPV genotyping (co-test) and the material taken is free of additional elements such as blood cells that interfere with the microscopic image. The two methods do not differ in terms of taking material from the cervix with a brush. However, at present it is still slide cytology that is reimbursed by the National Health Service. You have to pay for liquid cytology out of your own pocket, as well as HPV genotyping.
