Smear tests in pregnancy: Updated information
Clarification on smear tests for pregnant women
20th March 2013 - Women are often unsure whether they should have a smear test during pregnancy. Now the Royal College of Obstetricians and Gynaecologists (RCOG) has published new advice.
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 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).
Philippa Marsden of the RCOG's Patient Information Committee, says in a press release: "Women are often unsure whether they should have a smear or attend colposcopy in pregnancy. This new patient information is designed to clarify when it is important to attend and when it is alright to put it off until after the baby is born."
In the UK, cervical cancer is rare 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
The new RCOG patient information 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 three and six months of pregnancy.
What about colposcopy?
The RCOG advice also looks at the safety of attending for colposcopy when pregnant. It says 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.