Prenatal and postpartum Pap smears: do we need both?
OBJECTIVE
The need to perform a Pap smear at the time of entry to prenatal care, as well as at the postpartum check-up, is questionable. A comparison of the rates of recovery of endocervical cells and the incidence of dysplasia on the prenatal and postpartum Pap smears may be helpful in determining an optimal preventive care protocol for patients who are pregnant.


METHODS
Demographic and clinical data were collected from the records of 1,377 obstetrical patients at a midwest family practice residency. The yield of endocervical cells and the incidence of dysplasia was determined for both the prenatal and the postpartum Pap smears performed for this group of patients.


RESULTS
In women having both exams, endocervical cells were recovered in 44.1% of prenatal Pap smears compared to 82.0% of postpartum smears. The incidence of dysplasia was 2.6% on prenatal Pap smears and 4.8% on postpartum smears. In this study population, 33% of women did not return for their postpartum check-up.


CONCLUSIONS
The postpartum Pap smear is of value due to a significant yield of dysplasia. The sensitivity of the prenatal Pap test may be less than desired. Efforts directed toward increased patient compliance regarding the postpartum check-up are needed.
Londo
R
R
Department of Family and Community Medicine, University of Illinois College of Medicine-Rockford 61107.
Bjelland
T
T
Girod
C
C
Glasser
M
M
D000293:Adolescent; D000328:Adult; D002584:Cervix Uteri / Q000166:cytology*; D003710:Demography; D005194:Family Practice; D005260:Female; D006801:Humans; D065006:Papanicolaou Test; D010349:Patient Compliance; D011181:Postnatal Care; D011247:Pregnancy; D011295:Prenatal Care; D002578:Uterine Cervical Dysplasia / Q000175:diagnosis / Q000473:pathology; D014626:Vaginal Smears