Screening for cervical neoplasia during pregnancy.
OBJECTIVE
To evaluate cytology as a screening method for cervical neoplasia in pregnancy and to compare it with cervicography and the acetic acid test (AAT).


METHODS
In a large antenatal clinic in South Africa, 842 women were screened utilizing cytology, cervicography and the acetic acid test simultaneously. The proportion of positive results of the different tests were compared and the agreement calculated by the kappa statistic.


RESULTS
The mean age of the women was 27 years, and 12.5% smoked. Cytological smears were abnormal (low-grade squamous intra-epithelial lesion and higher degrees of abnormality) in 1.4% of cases, cervicography in 6.3% and the AAT in 14.3% (P = 0.5400). Kappa values were as follows: cytology vs. cervicography 0.01, cytology vs. AAT 0.0 and cervicography vs. AAT 0.2.


CONCLUSIONS
As a result of cytology's rather low yield and the small measure of agreement between the tests, cytology should be supplemented by an additional screening test in pregnancy.
Cronjé
H S
HS
Department of Obstetrics and Gynecology, University of the Orange Free State, Bloemfontein, South Africa. gnoghsc@med.uovs.ac.za
van Rensburg
E
E
Niemand
I
I
Cooreman
B F
BF
Beyer
E
E
Divall
P
P
D000293:Adolescent; D000328:Adult; D003127:Colposcopy; D005069:Evaluation Studies as Topic; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D008403:Mass Screening / Q000379:methods*; D008427:Maternal Health Services; D011247:Pregnancy; D011252:Pregnancy Complications, Neoplastic / Q000473:pathology* / Q000517:prevention & control; D012680:Sensitivity and Specificity; D013019:South Africa; D002583:Uterine Cervical Neoplasms / Q000473:pathology* / Q000517:prevention & control; D014626:Vaginal Smears; D002578:Uterine Cervical Dysplasia / Q000473:pathology*