Antepartum and postpartum Papanicolaou smears. Are they both necessary?

To determine if a Papanicolaou smear performed during pregnancy needs to be repeated at the postpartum visit.

A retrospective chart review was performed on women who received prenatal care from our obstetric clinic and returned for a postpartum visit. All pregnant women who had both a Papanicolaou smear in pregnancy and another at the postpartum visit, about six weeks after delivery, were included. Six hundred one patients were studied who had complete records between 1995 and 1996.

The average length of time between the two smears was 209 days. With the exception of a lower frequency of the presence of endocervical cells in the antepartum Papanicolaou smears, there were no differences between the distribution of Papanicolaou smear results. In patients without risk factors and a normal antepartum Papanicolaou smear, the prevalence of squamous intraepithelial lesion on the postpartum smear was very low (4 in 1,000).

In patients without risk factors for cervical intraepithelial neoplasia and a normal Papanicolaou smear in pregnancy, a Papanicolaou smear should be repeated at the recommended yearly interval.