Cervical cancer screening

-Automatic translation

Screening during pregnancy

A midwife explores a woman's screening history during the first antenatal care. If a woman has not attended a screening, it is recommended that a midwife take a cervical smear according to screening guidelines based on age or refer a woman to primary healthcare or a gynecologist.

If a woman receives an invitation to be screened during pregnancy and has not been under special surveillance due to abnormal cells, the screening can be postponed until after delivery.

Abnormal cervical smear in pregnant women

• The goal of a cervical smear is to rule out cancer. The same guidelines should be followed as for non-pregnant women.

• Women with abnormal cervical smears should be scheduled for a colposcopy as soon as possible.

• The optimal time for the first colposcopy during pregnancy is during weeks 13-14.

• A gynecologist experienced in colposcopy should perform colposcopy on pregnant women.

• Colposcopy should be evaluated in the same way as in non-pregnant women, taking the Swedescore into account.

• Bleeding after the cervical sample can be controlled with lapis, Monsell solution, or spongostan.

• Cervical scraping should not be done.
  

Colposcopy control during pregnancy

• Women diagnosed with high-grade changes ≥ CIN 2 early in pregnancy should be followed up with colposcopy and possibly biopsy in the first trimester and at the end of the second trimester. Women in the third trimester should be followed up with a colposcopy after delivery.

• Women who before pregnancy have received advice about a cone-section that has not been carried out or are under surveillance for CIN 2 changes must be monitored during pregnancy by the colposcopy clinic.

• Colposcopy after cone-biopsy or untreated CIN 1 can be delayed until after delivery.

• Women with AGC should be monitored in the same way as non-pregnant women.

• Women with AIS should be monitored during pregnancy with colposcopy. Supervision must be individual-based and in consultation with oncology surgeons at Landspítali.

Post-natal care

Women who have had a colposcopy during pregnancy should be followed up with a colposcopy or cone biopsy 6-12 weeks after delivery.