Document Detail


The effectiveness and safety of two cervical cytologic techniques during pregnancy.
MedLine Citation:
PMID:  9267375     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: There have been few studies documenting the optimal cervical cytologic technique in pregnancy. This study was initiated to investigate the effectiveness and safety of two standard techniques. METHODS: Two hundred twenty-two new obstetrical patients at a family practice residency program signed informed consent, were enrolled, and were randomized for cervical cytologic screening using either Zelsmyr Cytobrush and Ayre spatula or Dacron swab and Ayre spatula. The pathologists were blinded to the study, and results were reported with standard Bethesda System nomenclature. Patients were asked about complications at follow-up visits. Statistical analysis was performed using Fisher's exact test and the two-sample t test, with statistical significance set at P < .05. RESULTS: The Cytobrush-spatula technique yielded 95.6% (108/113) smears with adequate endocervical cells, as compared with 69.7% (76/109) of smears obtained with the Dacron swab and spatula (P = < .0001, odds ratio 9.38). Cytologic atypia, defined as noninflammatory cellular abnormalities, was uncovered on 15.9% (18/113) of the smears obtained with the Cytobrush and spatula technique and on 13.8% (15/109) of the smears obtained with the Dacron swab and spatula (P = .7082). The complication rate, which included spot bleeding and spontaneous abortion, occurred in 6.5% (7/108) of the smears obtained with the Cytobrush and 3.8% (4/105) of the smears obtained with the Dacron swab (P = .54). CONCLUSIONS: The Cytobrush-spatula technique significantly increased endocervical cell yield, did not increase detection of cytologic atypia, and did not increase the risk of adverse maternal or fetal outcomes when used for cervical cytologic screening during pregnancy. These results support the use of the Cytobrush-spatula technique over the swab and spatula for obtaining cervical cytologic smears in pregnancy.
Authors:
T Stillson; A L Knight; R K Elswick
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Publication Detail:
Type:  Clinical Trial; Journal Article; Randomized Controlled Trial    
Journal Detail:
Title:  The Journal of family practice     Volume:  45     ISSN:  0094-3509     ISO Abbreviation:  J Fam Pract     Publication Date:  1997 Aug 
Date Detail:
Created Date:  1997-09-08     Completed Date:  1997-09-08     Revised Date:  2005-11-17    
Medline Journal Info:
Nlm Unique ID:  7502590     Medline TA:  J Fam Pract     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  159-63     Citation Subset:  AIM; IM    
Affiliation:
University of Virginia School of Medicine, Carilion Health Systems Family Practice Residency, Roanoke, USA.
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MeSH Terms
Descriptor/Qualifier:
Adult
Equipment Safety
Female
Humans
Pregnancy*
Pregnancy Complications, Neoplastic / diagnosis*
Uterine Cervical Neoplasms / diagnosis*
Vaginal Smears / adverse effects*,  instrumentation*,  methods,  standards

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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