Evaluation and management of abnormal cervical cytology during pregnancy

Pregnancy is a particularly motivating time for a woman to access the health care system and seek out preventative services. Papanicolaou screening is a routine part of the initial examination. Although the vast majority of smears will have a normal result, it is important for providers to be aware of the appropriate evaluation of abnormal cervical cytology in this unique population because the standard management algorithms do not always apply. For example, colposcopy during pregnancy is a safe and effective tool, but endocervical curettage is contraindicated. In addition, for most diagnoses, more aggressive intervention is often best delayed.