Prevalence and associated risk factors of abnormal Pap Smear in first trimester of pregnancy

Abstract

 Among women, cervical cancers rank as the  fourth most common cancer occurring globally. Highest incidences are seen in low middle income countries (LMICs). The higher incidence rates are due to the lack of access to cervical cancer vaccines, regular screening, and early treatment programs. Pap Smear is a simple, cost effective and safe screening tool and is advised as a part of prenatal care to guarantee the early diagnosis of cervical abnormalities. The study aimed at determining the frequency of abnormal Pap smear results in women during the first trimester of pregnancy and identifying the associated risk factors.
Methodology: The cross-sectional observational study was carried out in the department of obstetrics & gynecology in peri-urban medical college, located in the central India. 314 first trimester pregnant women aged above 21 years were enrolled in the study. Interpretations of the Pap smear results were made using The Bethesda System 2014.
Results: Most participants, 96.18%, had Pap smear results indicating NILM (Negative for Intraepithelial Lesions or Malignancy). However, abnormal findings included 0.64% for Atypical squamous cells of undetermined significance (ASC-US), 2.55% for lowgrade squamous intraepithelial lesion (LSIL), and 0.64% for high  grade squamous intraepithelial lesion (HSIL). The abnormal findings were significantly high lower socioeconomic groups, age of first intercourse <21 years, low education status, and multiple sexual partners.
Conclusion: Pap smears are straightforward, cost-effective, and safe and should be part of prenatal treatment to detect cervical abnormalities early. Approximately 4% women had abnormal pap smear and were followed up for further management.