The postpartum Papanicolaou smear.

This study was performed to evaluate the importance of obtaining postpartum Papanicolaou (Pap) smears routinely. Four hundred eighty-nine patients receiving pregnancy care had a normal prenatal Pap smear and a repeat Pap smear at their postpartum visit. Twenty-four (4.9 percent) had an abnormal postpartum Pap smear (95 percent confidence interval: 3.1-6.9 percent). Twenty-one (87.5 percent) of the abnormal smears showed squamous dysplasia; three (12.5 percent) showed squamous atypia. No specific risk factors were identified that predicted the occurrence of an abnormal postpartum Pap following a normal prenatal Pap except for age. Women more than 30 years of age were less likely to have an abnormal postpartum Pap smear (P = 0.008). The results of this study support the practice of performing Pap smears during prenatal care and again at postpartum examination, even when the prenatal Pap smear is normal.