Cervical screening in pregnancy and post-partum

For some women, pregnancy may be the first opportunity to be screened.

Cervical samples can be taken at any time during pregnancy, particularly if the woman:

• has never been screened
• is overdue for a test
• has an abnormal screening history and is due for a test, or
• if there have been specific indications or recommendations for a follow-up test.

If the woman has a normal screening history, a decision may be made to delay screening until three months post-partum.

If indicated, a woman can be safely referred to colposcopy during pregnancy. It’s unlikely that a biopsy or treatment would be recommended when pregnant, but a colposcopic assessment can exclude the presence of invasive cervical cancer and provide reassurance.

The cervibroom is the recommended sampling instrument for all routine screening and screening during pregnancy. Cytobrushes are not to be used. While endocervical cells may not be sampled during pregnancy, this is not a cause for concern if there have been no previous glandular abnormalities.

Once the woman has given birth, cervical screening should be delayed for three months. When cervical screening is performed in the postnatal period, low levels of oestrogen associated with breastfeeding may make the collection or interpretation of the cervical sample unsatisfactory. If this occurs, consider the application of local oestrogen cream or pessaries.