Can a Pap Smear Cause a Miscarriage?

A Pap Test, Fortunately, is Not Likely to Cause a Miscarriage

Pregnant woman sitting on exam table, talking to doctor
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What is a Pap Smear?

Most doctors recommend getting a Pap smear (also known as a Pap test) in early pregnancy as a part of routine prenatal care. It usually takes just a few minutes. The test results are sent to a lab that checks for abnormal cervical cells, the presence of which could mean cervical cancer. If a Pap test does show that you have abnormal cervical cells, then your doctor might perform a second test called a colposcopy, which will allow him or her to look at your cervix more closely.

 

(Note: It's also a good idea to get regular Pap smears even when you're not pregnant. Your doctor will likely recommend getting your first Pap test by age 21—or three years after first having sexual intercourse—and then getting one every three years until age 29. It's generally recommended that women ages 30 to 65 get a Pap test—along with an HPV test—every five years. But ask your physician what the ideal frequency is for you.)​

What Happens During a Pap Test?

During a Pap smear, the woman undresses from the waist down, lies on her back on a table, spreads her legs, and puts her feet into stirrups. A sheet is placed over her thighs. The doctor uses a medical tool called a speculum, along with lubrication, to examine the cervix and then uses a small brush or spatula to swab a sample of cells from the cervix for testing. Some women feel nothing while others feel mild discomfort during this type of exam.

The more that you relax your body and vaginal muscles, the more comfortable the Pap test usually is. 

Can a Pap Smear Cause a Miscarriage?

Some women may experience light spotting after the test, due to the sensitivity of the cervix during pregnancy, but it's not likely that a Pap test would be able to inadvertently cause a miscarriage.

 How come? Usually, the fertilized egg is implanted higher up in the uterus and not near the cervix. Even in the event that the fetus is implanted lower in the uterus and closer to the cervix, the cervix is quite thick in the first trimester, so the light scraping from a Pap test would not disturb an implanted fertilized egg.

Unfortunately, given that roughly 15 to 20% of confirmed pregnancies end in miscarriage, some women do inevitably miscarry after having a Pap smear. Some may even start having symptoms of miscarriage after having had a Pap smear earlier that same day. Symptoms of miscarriage might include vaginal bleeding that's bright red or brown, cramping or back pain, and the passing of tissue through the vagina. But keep in mind: This does not mean that the Pap smear necessarily caused the miscarriage. It's far more likely that the miscarriage symptoms coincidentally happened to appear right after the test.

Nevertheless, if you are worried about getting a Pap test during early pregnancy, discuss your concerns with your prenatal care provider.

It's possible that your doctor or midwife will agree to postpone the Pap test until your postpartum checkup, especially if you have a history of normal Pap results.

Sources:

Pap Smear. American Pregnancy Association. Accessed: 12 Jan 2010. http://www.americanpregnancy.org/womenshealth/papsmear.html​​

Buchmayer, S., Sparén, P., Cnattingius, S. "Signs of infection in Pap smears and risk of adverse pregnancy outcome." Paediatr Perinat Epidemiol. 2003 Oct;17(4):340-6.

http://cervicalcancer.about.com/od/screening/a/papsmearexpect.htm

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