Cytology in pregnancy

Cytology in pregnancy-when to perform?

After breast cancer, cervical cancer is the second most commonly detected cancer in pregnant women and in the postpartum period. For this reason, the obligation to perform cytology during pregnancy is included in the current Organizational Standard for Perinatal Care. According to it, any pregnant woman who has not had a cytology within 6 months before pregnancy should have this test done during the 1st. visits to a gynecologist during pregnancy. In most cases, this occurs by the 10th. week of its duration. Of course, if for some reason the test is not done, it can be done in the following weeks of pregnancy. Many gynecologists perform cytology on their pregnant patients regardless of how long it has been since the previous test.

Cytology in pregnancy-result

The cytology result is determined based on the Bethesda system and should be interpreted by a gynecologist. A normal cytological result is referred to as NILM (in the former Papanicolau system Group I and II). Abnormal results are: LSIL, ASC-US, HSIL, ASC-H, AGC.

If an LSIL or ASC-US result is obtained, a follow-up cytology 6 months after delivery is recommended. If you have a HSIL, ASC-H or AGC result, it is necessary to have an immediate colposcopy, followed by colposcopy and cytology every 12 weeks during pregnancy and every 6 weeks after delivery. Conization is mainly performed between 2 and 8 pm. week, after consultation with a gynecologic oncologist, on suspicion of invasive cervical cancer. The good news is that most of the detected lesions regress in the postpartum period. Invasive cervical procedures during pregnancy, however, are avoided.

Cytology in pregnancy-traditional or liquid?

In recent years, specialists have been paying increasing attention to the advantages of liquid cytology-LBC over traditional cytology, the so-called “liquid cytology”. vitreous. This is due to the fact that with liquid cytology it is also possible to perform HPV genotyping (Co-Test),  and the collected material is devoid of additional elements such as blood cells, interfering with the microscopic image. The two methods do not differ in terms of collecting material from the cervix with a toothbrush. Currently, however, 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 for HPV genotyping.