Significance of Persistent Inflammatory Cervical Smears in Sexually Active Women of Reproductive Age Group—A Prospective Study

Abstract

ABSTRACT To study the significance of persistent inflammatory cervical Papanicolaou smears, in sexually active women of reproductive age group attending the out patient department of department of obstetrics and gynecology, Sarojini Naidu Medical College and Hospitals, Agra were recruited. Patients with persistent inflammatory cervical smears were subjected to Schiller directed cervical biopsy for histopathological examination. Persistent inflammatory changes were seen in 37.6% cervical smears. Underlying cervical intraepithelial neoplasia (CIN) on histopathologic examination was found in 13.6% persisters. Prevalence of CIN was higher in women over 30 years and significantly so in women with parity higher than 2. It was further observed that severity of underlying CIN lesions increased with increasing duration of marital life. Objective To study the significance of persistent inflammatory cervical smears in sexually active women of reproductive age. Study design A prospective tertiary teaching hospital based study on 3000 sexually active women aged between 18 to 45 years attending the OPD from October 2006 to December 2008. Material and methods Sexually active women aged between 18 to 45 years with inflammatory smears attending the OPD of the department of obstetrics and gynecology, SN Medical College and Hospital were recruited for the study. Repeat cervical smears were taken after 3 months of systemic antimicrobials plus local antiseptics. Patients with persistent inflammatory cervical smears were subjected to Schiller directed cervical biopsy for histopathological examination. Relationship of age, parity, duration of marital life, different contraceptive practices and other high-risk factors were studied vis-ì-vis histopathological findings of cervical intraepithelial neoplasia. Results Persistent inflammatory changes were noted in 37.6% cervical smears. Underlying cervical intraepithelial neoplasia (CIN) on histopathalogic examination was seen in 13.6% persisters. Prevalence of CIN was higher in women over 30 years, and over para 3 uninfluenced by the presence of cervical lesion. Severity of underlying CIN lesions increased with increasing duration of marital life. Conclusion Women with persistent inflammatory cervical smears, especially if she is above 30 years, sexually active for 10 years and is third para, should have further evaluation with cervical biopsy.