PAP SMEAR.pptx

Pap smear

1. PURPOSE Provides guidelines for OB Gyne doctors for collection of PAP SMEAR Prevent errors in collection of PAP SMEAR

2. DEFINITION A Pap smear , also called a Pap test , is a screening procedure for  cervical cancer . It tests for the presence of precancerous or cancerous cells on your cervix.

3. EQUIPMENTS Cytology request Vaginal Speculum Cervical Brush Spatula Glass Slide Fixative Solution

4. POLICY Screen sexually active women for precancerous lesions of the cervix. Ensure Pap Smear properly collected ,labeled & documented Pap smear to be started 3 years after vaginal intercourse,no earlier than age 21 Women aged 21 -29 years ,should be test every 3years . Beginning at age 30 ,the preferred way to screen with Pap Test combined with HPV test every 5 years. This is called co testing and should continue until age 65. Women who are high risk of cervical cancer because of suppressed immune system ,for ex from HIV infection ,organ transplant ,or long term steroid use. Women who had a total hysterectomy ( removal of uterus and cervix ) should stop screening unless hysterectomy was done as a treatment for cervical pre cancer . Women who have been vaccinated against HPV should still follow these guidelines

5. PROCEDURE Women should have pAP Smear when she is not menstruating,best time at least 5 days after the end of menstrual period. For about 2 days before testing ,woman should avoid douching or using spermicidal foams ,creams or jellies or vaginal medicines except directed by physician . These may wash away or hide abnormal cervical cells No intercourse during 48h prior the test

6. PROCEDURE The women placed on examination table ,clinician will examine outside of the patients genital and rectal areas ,including urethra to assure they look normal The Doctor insert speculum into the vagina so the wall of the vagina and cervix can be seen clearly Cotton swab is sometimes used to clear away mucus that might interfere with an optimal sample Endocervical sample to be taken by inserting the cervical brush into the opening of the cervix and twirled around to collect a sample of cells Endocervical samples also collected as part of the PAP smear .These cells are collected from a scraping the area surrounding ,but not entering the cervical os Both endocervical and ectocervical samples gently smeared on a glass slide, and a fixative ( preservative) is used to prepare cells on the slide for laboratory evaluation (conventional method ) with liquid based methods the specimen is place in to a liquid fixative solution A bimanual exam usually follows the collection of the two samples for the PAP smear Sample will be labeled ,patient name ,date and file number Doctors will advise patient to get appointment after 2 weeks for follow up of result Under the Bethesda System ,pap smear samples that have no cell abnormalities are reported as negative for intraepithelial lesion or malignancy .