Is Postnatal Cervical Smear of Significant utility in detecting Intraepithelial Neoplastic Changes?

Abstract

Background: Opportunistic cervical screening is common in the postnatal period. This study aims to evaluate its utility in detecting cervical intraepithelial neoplastic changes. Method: A review of cervical smears diagnosed from 3 teaching hospitals(Aminu kano Teaching Hospital Kano,kano state, Ahmadu Bello University Teaching hospital,Kaduna State and Usmanu Danfodiyo University Teaching Hospital,Sokoto state) in northwestern Nigeria between January, 2017 and December, 2019; comparing the rate of positivity of postnatal smears with non-natal smears. Results: 4,717 smears were reported in the study period 20% (941) of which were post-natal smears while the remaining 80% (3,776) were non-natal smears. Of these only 1 (0.1%) of the 941 postnatal cases screened was positive while 86 (2.3%) of the 3,776 non-natal smears were positive; giving a statistically significant higher rate of positivity (p = 0.00001). Conclusion: Targeting women in the postnatal period may not be a very useful strategy in combatting the scourge of cervical cancer due to high likelihood of not only false negative smears but also because of very low coverage.