Cervical Cytology and its Correlation with Cervicovaginal Infection in Antenatal Patients: A Study in a Tertiary Care Hospital

Abstract

To study cervical cytology and cervicovaginal infection in antenatal women.Objectives: To find out by pap smear for inflammatory, atypical squamous cells of undetermined significance (ASCUS), atypical glandular cells of undetermined significance (AGUS) and premalignant lesions in antenatal women.• To find out cervicovaginal infection by wet mount among antenatal women.• Correlation of cervical cytology with cervicovaginal infection.Materials and methods: Five hundred antenatal women, irrespective of gestational age, were enrolled as subjects in this prospective clinical study for blood investigations, wet mount examination of cervical discharge and pap smear.Results: Out of 500 smears, 385 women were having inflammatory smears out of which 301 were having bacterial vaginosis followed by 89 vaginal candidiasis followed by 12 were having trichomoniasis, in which 339 had a preterm delivery. Conclusion:Antenatal visits are a potential opportunity to perform screening by Pap smear and wet mount study to prevent preterm labor and improve perinatal mortality.

Vulvovaginal yeast infections during pregnancy and perinatal outcomes: systematic review and meta-analysis

“…Among the 57 included studies, 22 (38.6%) described whether participants had reported symptoms and assessed symptom status. Of these 22 studies, 17 included participants with symptoms (14 reported the percentage of participants with symptoms) [ 24 , 29 , 39 , 42 , 43 , 45 – 47 , 58 , 59 , 65 , 67 , 69 , 77 – 79 , 84 ] and five studies included only participants without symptoms [ 55 – 57 , 70 , 82 , 83 ]. Reporting about symptom in terms of self-reported or clinician-observed symptoms and the level of detail varied between studies.…”

“…Reporting about symptom in terms of self-reported or clinician-observed symptoms and the level of detail varied between studies. Of the 22 studies, eight studies reported symptoms observed by the clinician [ 42 , 45 , 46 , 54 , 59 , 67 , 69 , 77 ], two only self-reported [ 43 , 78 ], five studies both [ 29 , 58 , 65 , 79 , 82 ] and seven did not reported if the symptoms were self-reported or clinician-observed [ 24 , 39 , 47 , 55 – 57 , 70 , 83 ]. Of the 17 studies which included participants with symptoms, six studies report proportions of different types of vaginal discharge and other symptoms which are associated with genital tract infections [ 29 , 43 , 47 , 54 , 65 , 67 ], ten reported if symptoms from a defined group of symptoms were present or absent [ 24 , 39 , 42 , 45 , 58 , 59 , 69 , 77 – 79 ], one did not report the type or definition of symptoms [ 46 ].…”

“…Within groups according to symptom status, heterogeneity was mostly low (Table 2 ). The OR for preterm birth was 1.44 (95% CI 0.92–2.26, I 2 0%) in two studies with ≥ 50% participants with symptoms [ 24 , 29 ], 0.84 (95% CI 0.45–1.58, I 2 88%, prediction interval 0.10–6.81) in seven studies with < 50% participants with symptoms [ 43 , 45 – 47 , 65 , 78 , 79 ], 1.12 (95% CI 0.94–1.35, I 2 0%, prediction interval 0.75–1.68) in four studies only with participants without self-reported or observed symptoms [ 55 , 56 , 70 , 82 , 83 ], and 1.05 (95% CI 0.87–1.26, I 2 2%, prediction interval 0.70–1.57) in 17 studies in which symptom status was not reported [ 27 , 28 , 32 , 37 , 40 , 44 , 50 , 53 , 61 , 63 , 64 , 66 , 68 , 72 , 74 – 76 ]. The prediction intervals for all groups with sufficient data included the null value.…”

“…Heterogeneity assessed by the I 2 test was very low. One study by Goel et al was an outliner in which vulvovaginal yeast infections were associated with lower odds of preterm birth [ 47 ]. Goel et al (2018) enrolled 500 pregnant women at any gestational age from a medical institute in India.…”

“…Preterm risk factors were not part of the enrolment criteria. This study reported that 67.8% of women had a preterm delivery, but there was no definition of preterm delivery nor any discussion about the high number of preterm deliveries [ 47 ].…”