Do a Pap smear before getting pregnant
Dear Dr Mitchell,
Do I need to do a Pap smear before I get pregnant? What about if I get pregnant and hadn’t had one for a few years? Would the test be done during the pregnancy, or right after?
A Pap smear is a screening test for early detection of cervical cancer. The Pap smear helps to pick up abnormal cells early so that this can be treated to prevent the progression to cancer of the cervix.
The Pap smear should be done starting at the age of 21 years, or two years after the start of sexual intercourse if this occurs before age 21. The frequency of testing varies depending on where you live and your personal risk factors for cervical cancer. In some countries the Pap smear is done once every two to five years, especially if there is a well organised screening system in place at the national level.
Some of the risk factors that increase your chances of developing cervical cancer include:
•A weak immune system from Human Immunodeficiency Virus (HIV);
•Diabetes mellitus;
•Steroid usage;
•Multiple sexual partners;
•Vulval, vaginal or cervical infection with the human papillomavirus (HPV);
•History of an abnormal Pap smear or past history of cervical cancer.
In these instances there will be the need for more frequent screening with the Pap smears. In some cases the Pap smear is done every four to six months.
It is important to do a Pap smear before becoming pregnant so that if abnormal cells are present treatment can be undertaken. Cervical cancer is caused by HPV so if you have genital warts this increases the risk of transmission to the newborn baby, resulting in an increased risk for cancer of the throat. It is absolutely important for women to have a proper check-up and a Pap smear before pregnancy. If this is not done a Pap smear should be done at the first visit to your doctor in the pregnancy.
In some situations a swab can be done to test for the high-risk HPV that causes cervical cancer. If this is negative then your risk for cervical cancer is significantly reduced. This is usually done in women over age 30 since HPV infection is common in young women under 30 years and might not be of any clinical significance since younger women are able to clear the virus from their system readily because of a good immune system.
There are vaccines widely available to prevent the development of genital warts and cervical cancer. These are usually given in two doses to young girls under the age of 15 years and in three doses to all women over 15 years up to the age of 65 years. This will significantly reduce your risk of developing cancer of the cervix, anus, and throat.
Consult your doctor who will advise you further.
Best regards.
Dr Sharmaine Mitchell is an obstetrician and gynaecologist. Send questions via e-mail to allwoman@jamaicaobserver.com; write to All Woman, 40-42 1/2 Beechwood Ave, Kingston 5; or fax to 876-968-2025. All responses are published. Dr Mitchell cannot provide personal responses.
DISCLAIMER:
The contents of this article are for informational purposes only, and must not be relied upon as an alternative to medical advice or treatment from your own doctor.
