Pregnant but due a smear test, a little anxious

[Mothership241]

I'm in my early-mid 20's and recently received two letters from my GP telling me I'm due a smear and to book an appointment, the problem is I'm pregnant (20 weeks) and the general consensus seems to be that you have to wait until you're three months postpartum.

A friend (25) recently found out that she'd had cervical cancer (or the onset of it - not completely sure of the wording) but thankfully she went at the right time and they managed to remove enough of the cells during laser treatment and a biopsy for her to be deemed in the clear for now. She had no symptoms whatsoever.

I'm quite health anxious in general and want to be proactive when it comes to smears so I'm a bit edgy about having to now wait well into next year to have one.

if there was anything for me to worry about such as an abnormal cervix or HPV would it be detected at all during pregnancy? I had an internal vaginal scan early on in the pregnancy, I have routine blood tests at the midwifes also.

If I had abnormal cells now could it progress dangerously by the time I'm able to have a smear? (due in April so smear approx July)

Haven't been diagnosed with HPV in the past and don't have any abnormal bleeding or any huge cause for concern - I'm just a bit alarmed about my friends results and it's got me to worrying about my own health and smears.

Also I haven't had the cervical cancer vaccination that is offered to under 18's so I worry that I'm more vulnerable to abnormalities than somebody who has had the vaccination.

Bump

I ended up pushing smears back twice for pregnancy and all was well. Im not a doctor so can't reassure you on any delays if there were a problem, but think it is probably quite common for womem to delay smears for pregnancy so I wouldn't stress about it.

It’s very common to delay smears due to pregnancy. I had treatment for abnormal cells and had 6 monthly smears but pregnancy meant that I couldn’t have one for over a year, all fine.
It is (generally) a very slow process for abnormal cells to develop into cancer (if indeed they’re going to, it’s not always the case).

Talk to your practice nurse about it and you can discuss your clinical history and whether it's appropriate to wait to have it post natally.

They can then delay the invitation letters until you are able to have a test. Otherwise you'll probably go through the recall cycle of invite letters in the meantime and be reset to be called in 3 year's time.

If I had abnormal cells now could it progress dangerously by the time I'm able to have a smear?

No. If you are otherwise healthy/ have a normal immune system etc. then it takes about 10-15 years for the abnormal cells to develop into cancer.

I got my first letter the day after I found out I was pregnant. My midwife asked if I'd had a smear and she said to wait until 12week PP. I think DS was 16 weeks-ish when I went and all was good.

My last smear i was about 6/7 weeks pregnant, I told the nurse and she just said 'ok that's fine!' So had the test..

Thank you ladies

I wasn't giving it much thought until my friend told me about her situation today, then it really hit home how important smear tests are.

It's frightening how somebody so young can have a problem escalate to the point where its dangerous and could have been fatal if she hadn't gone in when she did.

I didn't know that there was a recall cycle of letters which can be re set to you not being invited in for another three years, I'll have to have my GP put a note on my file that I've had to delay due to pregnancy but definitely want one next year (and not in another three)

@Bigonesmallone3 ah I see! So some doctors/nurses will go ahead and do them during pregnancy?

I'd much prefer to not have to wait, providing it's not dangerous to baby of course.

You won’t have to wait three years.

If you’re eligible for a smear then you can attend any time. It’s best to wait until you’ve had your baby and it’s at least 12 weeks old, I’m surprised the nurse mentioned above happily did a routine smear in pregnancy. We avoid doing them.

Cervical screening and pregnancy
In most cases, it's not recommended that a woman has a cervical screening test while she is, or could be, pregnant. This is because pregnancy can make the result of your test harder to interpret.
If you're planning a pregnancy, it’s a good idea to ask your GP if you are up to date with your cervical screening. This means that any tests or treatment can be arranged around the pregnancy.
If you are already pregnant and are due for a cervical screening test, the test will usually be postponed until 3 months after your baby is born. Tell your GP or clinic that you are pregnant when you are invited for your test.
However, if you have previously had an abnormal result from a cervical screening test, you may need to be screened while you are pregnant. Your GP or midwife may ask you to have a cervical screening test at your first antenatal appointment. This test will not interfere with your pregnancy.

@Sidge is there a known risk associated to smears during pregnancy, then?

I'm not very clued up to be honest so didn't know the reasons for and against during pregnancy.

@memoriestwilight thanks for the info!

She did for mine 🤷‍♀️
Maybe it was ok coz I was so early..

No it’s not so much about risk, as a potential for an inaccurate result due to hormones. This is also the case afterwards, hence why you shouldn’t dash down after delivery!

They used to do smears at your postnatal check at six weeks or so, but realised that many results were abnormal and needed repeating as the cervix was still changing so no benefit from doing them then as they needed repeating a few months later.

I had a smear at 6 weeks pp and got an abnormal result, which gave me weeks of stress till I was retested.
It was only afterwards the nurse told me it shouldn’t have been done at my check up and I should be 12 weeks or more pp. my gp did the smear too so you would think she should have known better.

Ah I see, then that makes a lot of sense.

I'm a habitual worrier and if I got an abnormal result because of inaccurate results (due to pregnancy hormones) I'd panic no end and be under no end of stress so it would be completely counterproductive.

The bit about 3 years would be if no note was put on your file. It doesn't mean you have to wait 3 years - you can go anytime if you've been called - you just won't get reminded to go for screening for another 3 years. Sorry I should have been clearer about that.
The screening system invites women 6 weeks before they're due for screening. It then sends reminder letters, usually 2 or 3 over approx a 9 month period. If you don't attend then the recall date is set for another 3 years.
Anyone who's on follow up for an abnormal test will get recalled more frequently. Depending on the history then the cycle of invitation letters kicks off every 12 months.

Post natal (as in very pn) samples can be really difficult to interpret due to the hormonal pattern. As Sidge says it's easier to read them if it's left a bit longer.