Pap smear abnormalities in patients with abnormal vaginal discharge

Abstract

Introduction: Cervical cancer is a major cause of morbidity and mortality in gynecology clients. It is the leading cancer among women in developing countries. Evaluation of screening performance for effective, feasible, and affordable early detection and management methods is a public health priority.

Objective: To determine the frequency of Pap smear abnormalities in patients presenting with abnormal vaginal discharge and bleeding at a tertiary care hospital.

Materials & Methods: This cross sectional study was conducted in the Department of Gynecology & Obstetrics, MTI-Khyber Teaching Hospital, Peshawar, from September 2021 to April 2022 on 287 patients presenting with various gynecologic indications for performing a Pap smear. Pap smear was performed with the Ayers spatula by the standard method of rotating it at an angle of 360⁰  in the cervix so that cells can be properly picked up from the squamocolumnar junction. Data were entered and analyzed by SPSS 20 for descriptive statistics.

Results: As per Pap smear abnormalities, 59 (20.6%) patients had dense inflammatory infiltrate and blood, 82 (28.6%) patients had inadequate sample, 62 (21.6%) patients had low squamous neoplasia, 64 (22.3%) patients were negative for intraepithelial abnormalities or malignancy, and 20 (7.0%) patients had epithelial cell abnormality (CINI, CINII, CINIII).

Conclusion: Papanicolaou smear is an effective screening test for detection of abnormalities such as the absence of endocervical or transformation zone and malignancy.