Screening for Cervical Pathologies in Antenatal Women Using Pap Smear at First Visit in a Tertiary Care Hospital: A Prospective Observational Study.

Uzma Amtul  Shukoor  Farooqui; B. Sumalatha; Bushra  Fatima; Prithivi  Perum

doi:10.51168/sjhrafrica.v6i6.1806

Authors

Dr.Uzma Amtul Shukoor Farooqui Senior Resident, Department of Obstetrics and Gynecology, Osmania Medical College, Hyderabad, India
Dr.B. Sumalatha Associate Professor, Department of Obstetrics and Gynaecology, Government Medical College, Siddipet, Telangana, India
Dr.Bushra Fatima Associate Professor, Department of Obstetrics and Gynaecology, Osmania Medical College, Hyderabad, Telangana, India.
Dr. Prithvi Perum Senior Consultant in Obstetrics and Gynaecology, Medicover Woman and Child Hospitals, Hyderabad, Telangana, India

DOI:

https://doi.org/10.51168/sjhrafrica.v6i6.1806

Keywords:

Pap smear, cervical cancer, antenatal women, Bethesda classification, Low-grade Squamous Intraepithelial Lesion, High-grade , Squamous Intraepithelial Lesion, cervical screening, pregnancy

Abstract

Background

Cervical cancer remains one of the leading causes of morbidity and mortality among women in India. Despite the proven effectiveness of early detection through Pap smear screening, uptake remains limited, particularly during pregnancy a period that offers an ideal opportunity for screening and education.

Objectives

To assess the prevalence of cervical pathologies among antenatal women attending their first antenatal visit using Pap smear screening and to identify the frequency of pre-malignant and malignant cervical lesions.

Methods

This prospective observational study included 200 pregnant women attending their first antenatal visit at Niloufer Hospital, Hyderabad, between April 2021 and October 2022. After informed consent, Pap smears were collected and interpreted using the Bethesda 2001 classification. Demographic and obstetric profiles were recorded.

Results

The mean age was 26.05 ± 6.66 years; 69% were illiterate, and 57.5% were housewives. Pap smear findings revealed inflammatory smears in 37.5%, ASC-US in 10%, LSIL in 4%, and HSIL in 2.5%. Reactive cellular changes were noted in 8.5%, while 35% had normal cytology. The prevalence of pre-malignant lesions (LSIL and HSIL combined) was 6.5%. Only 3.5% of samples were unsatisfactory. Most participants were unaware of cervical screening and belonged to low socioeconomic backgrounds.

Conclusion

Pap smear screening during antenatal visits is both feasible and valuable for detecting cervical abnormalities in underserved populations. A notable prevalence of 6.5% pre-malignant lesions highlights the importance of early detection. Integrating Pap smear into routine antenatal care offers a strategic opportunity to improve awareness, initiate timely referrals, and reduce the burden of cervical cancer.

Recommendations

Integrate routine Pap smear screening into antenatal care to enhance early detection of cervical lesions, improve awareness, and ensure timely referrals, especially among underserved and low-literacy populations.

Author Biographies

Dr.Uzma Amtul Shukoor Farooqui, Senior Resident, Department of Obstetrics and Gynecology, Osmania Medical College, Hyderabad, India

Dr. Uzma Amtul Shukoor Farooqui is currently serving as a Senior Resident in the Department of Obstetrics and Gynecology at Osmania Medical College, Hyderabad. She completed her MBBS from Kakatiya Medical College and pursued her MS in Obstetrics and Gynecology from Osmania Medical College. With a strong academic background and clinical expertise, Dr. Uzma is committed to advancing women's health through research and evidence-based clinical practice. Her areas of interest include maternal health, cervical cancer screening, and reproductive care in underserved populations. She actively participates in academic and community health initiatives aimed at improving outcomes in obstetric and gynecological care. ORCID ID: https://orcid.org/0009-0000-6285-1554

Dr.B. Sumalatha, Associate Professor, Department of Obstetrics and Gynaecology, Government Medical College, Siddipet, Telangana, India

Dr. B. Sumalatha is an Associate Professor in the Department of Obstetrics and Gynaecology at Government Medical College, Siddipet. She earned her MBBS from Kamineni Institute of Medical Sciences, Nalgonda, and completed her MD in Obstetrics and Gynaecology from Gandhi Medical College, Secunderabad. With over seven years of teaching experience, Dr. Sumalatha is dedicated to both medical education and clinical excellence. Her professional interests include maternal-fetal medicine, high-risk obstetrics, and women's reproductive health. She is actively involved in academic mentoring and continues to contribute to research and healthcare initiatives aimed at enhancing maternal and neonatal outcomes in public healthcare settings. ORCID ID: https://orcid.org/0009-0008-2533-3713

Dr.Bushra Fatima, Associate Professor, Department of Obstetrics and Gynaecology, Osmania Medical College, Hyderabad, Telangana, India.

Dr. Bushra Fatima is an Associate Professor of Obstetrics and Gynaecology at Osmania Medical College, MGMH Petla Burj, Hyderabad, Telangana, India. She completed her MBBS from Kamineni Institute of Medical Sciences, Narketpally, Telangana, and obtained her MS in Obstetrics and Gynaecology from Prathima Institute of Medical Sciences, Karimnagar, Telangana, in 2015. With over seven years of teaching experience, she has mentored numerous postgraduate students and is known for her dedication to academic excellence and clinical training. Dr. Fatima has completed a fellowship in infertility, and her areas of special interest include high-risk obstetric care and infertility management. She is actively engaged in both clinical practice and research. ORCID ID: https://orcid.org/0009-0009-3783-3974

Dr. Prithvi Perum, Senior Consultant in Obstetrics and Gynaecology, Medicover Woman and Child Hospitals, Hyderabad, Telangana, India

Dr. Prithvi Perum, MBBS, MS (OBGYN, Gold Medalist), FMAS, DMAS, Fellowship in Fertility (OASIS Institute), Consultant Robotic and Laparoscopic Surgeon. Dr. Prithvi Perum is an accomplished Consultant Robotic and Laparoscopic Surgeon with over 17 years of clinical and academic experience in the field of Obstetrics and Gynecology. Currently practicing at Medicover Hospitals, Hyderabad, she is widely recognized for her surgical precision, academic contributions, and dedication to women's health.

She completed her MBBS from SVS Medical College, Mahabubnagar, Andhra Pradesh, in 2007, with a strong academic record, achieving a cumulative score of 70%. Driven by a passion for women’s health, she pursued postgraduate studies in Obstetrics and Gynecology at SVS Medical College and was awarded the Gold Medal for academic excellence.

In her pursuit of specialization, Dr. Prithvi obtained a Fellowship in Fertility from the OASIS Institute, further enhancing her expertise in reproductive health. She holds prestigious certifications in Fellowship in Minimal Access Surgery (FMAS) and Diploma in Minimal Access Surgery (DMAS), having trained under the esteemed Dr. R.K. Mishra. To support her academic contributions, she has also undergone formal teaching training for both undergraduate and postgraduate medical education at a recognized Regional Training Centre.

Dr. Prithvi began her professional journey with an internship at Gandhi Hospital (2006–2007) and later worked as a Medical Officer in Pulmonary Medicine at Apollo Hospitals, Hyderabad (April–October 2009). She served as a Junior Resident at SVS Medical College from 2014 to 2017, followed by a year as a Senior Resident at Kondapur Area Hospital (2017–2018). In 2018, she joined the Department of OBGYN as an Assistant Professor, and her outstanding service led to her promotion as Associate Professor in August 2023. Known for her advanced proficiency in laparoscopic and robotic surgeries, Dr. Prithvi specializes in the management of complex gynecological conditions using minimally invasive techniques that offer faster recovery and improved outcomes. Her areas of expertise include fertility treatment, high-risk obstetrics, endometriosis management, fibroid surgery, and uterine anomalies.

Dr. Prithvi Perum is celebrated not only for her clinical acumen but also for her commitment to mentoring future generations of doctors. Her career reflects a deep dedication to the advancement of women’s health, academic excellence, and patient-centered care. ORCID ID: https://orcid.org/0009-0006-3457-3415

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