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Should I have a smear test if I'm pregnant?


WebMD Medical Reference
Medically Reviewed by Dr Rob Hicks
doctor and patient

Women are often unsure whether they should have a smear test or attend colposcopy during pregnancy. Get the facts here.

Most women in the UK start having smears by the age of 25 so it's not unusual to be called for a smear test during pregnancy. The Royal College of Obstetricians and Gynaecologists (RCOG) says women who are invited for their routine smear test whilst they are pregnant can usually wait until after their baby is born, but there are circumstances when they should still attend for their smear or colposcopy (examining, but not necessarily treating, the cervix under magnification).

Screening

In the UK, cervical cancer is uncommon because women are offered regular free testing to detect any changes in the cervix (neck of the womb) before they become cancerous.

If a smear test is abnormal women may be referred for an investigation called a colposcopy which looks at the cervix in more detail.

When a smear can wait

RCOG recommends that women who are called for a routine smear test while pregnant should delay until after their baby is born. The NHS says this is because pregnancy can make the test result harder to interpret.

Women should let their GP know they are delaying a test so they can be invited again. The delayed appointment will usually be three months after the baby is due.

When a smear test is still needed

If women are called for a repeat smear following a previous smear abnormality, the RCOG says they should have the smear test whilst pregnant. This should ideally be done between 3 and 6 months of pregnancy.

What about colposcopy?

Colposcopy can often be postponed until after the baby is born, but if you do need the procedure it does not harm the baby and can provide valuable and reassuring information.

Women should attend for colposcopy while pregnant if they have already had treatment for an abnormality called cGIN (where glandular cells inside the cervix appear abnormal), regardless of whether the doctor was sure all abnormal cells were removed. 
Women should also attend if treatment for an abnormality called CIN 2 or CIN 3 (where abnormal cells are found on the surface of the cervix) has been carried out and the doctor was not sure whether all the abnormal cells were removed. If all abnormal cells were removed, then it is safe to wait until after the baby is born before attending.

RCOG recommends that if you are unsure whether you need to attend for colposcopy you should contact your clinic for more advice.

Previous treatment

The majority of women who have had treatment to the cervix will go on to have a successful pregnancy and deliver a healthy baby at the normal time. However, there is a small risk of having a preterm birth in women who have had an excisional biopsy (where a piece of tissue is removed from the centre of the cervix with the aim of removing all the abnormal cells).

If you are unsure about any previous treatment, contact your colposcopy clinic or GP who will have the appropriate information on record and will be able to advise you on what to do.

If you are planning a pregnancy, it is a good idea to check with your GP that you are up to date with your cervical screening. That way, if you are due to be screened, the test and any treatment you may need can be carried out before you become pregnant.

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Reviewed on March 20, 2013

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