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Pap Smears during Pregnancy
During your first visit to your healthcare provider, you probably had a Pap smear. A Pap smear is usually done at the beginning of pregnancy. By now, the result is back and you have discussed it with caregiver, particularly if it was abnormal.

The Pap smear (short for Papanicolaou smear) is a screening test done at the time of a pelvic exam. It identifies cancerous or precancerous cells coming from the cervix, which is located at the top of the vagina. This test has contributed to a significant decrease in mortality from cervical cancer because of early detection and treatment.

An Abnormal Pap Smear
If you have had an abnormal Pap smear or have been treated for an abnormal Pap test, continue to get checked as your caregiver suggests. Pap smears are screening tests. If a test is abnormal, your healthcare provider must verify the findings and decide on treatment. If you are not pregnant, most doctors will suggest a biopsy of the cervix.
Women who deliver vaginally may see a change in abnormal Pap smears. One study showed that 60% of a group of women who were diagnosed with high-grade squamous intra-epithelial lesions in the cervix before giving birth had normal Pap smears after their baby was born.

An abnormal Pap smear during pregnancy must be handled individually. When abnormal cells are "not too bad" (premalignant or not as serious), it may be possible to watch them during pregnancy with colposcopy or Pap smears; biopsies are not usually done at this time. The cervix bleeds easily during pregnancy because of changes in circulation. This situation must be handled carefully.

When Is a Biopsy Necessary?
A biopsy of the cervix is done in your doctor's office, without anesthesia, with colposcopy. Colposcopy is a procedure that uses an instrument similar to a pair of binoculars or a microscope to look at the cervix. This enables your doctor to see where abnormal areas are so biopsies can be taken. Most obstetricians/gynecologists are able to do this procedure without sending you to a specialist.

A biopsy provides a better idea of the nature and extent of the problem. If there is a possibility that abnormal cells could spread to other parts of the body, a cone biopsy may need to be done. A cone biopsy precisely determines the extent of more severe disease and removes abnormal tissue. This surgery is done with anesthesia but is not usually performed during pregnancy.

Treating Abnormal Cells
There are several ways to treat abnormal cells on the cervix, but most treatment methods cannot be performed during pregnancy. These treatments include surgically removing the abnormal spot (if it can be seen), electric cautery to remove or "burn" small abnormal spots, cryocautery to freeze small lesions, laser treatment to destroy abnormal areas on the cervix and cone biopsy for more-involved lesions.