CHAPTER 4: SCREENING FOR CERVICAL CANCER

116PS 8: Taking a Pap SmearPS 8PS 8: Taking a Pap SmearTAKING A PAP SMEARNote the following:• It is best not to take a smear from women who are actively menstruating or havesymptoms of an acute infection. Slight bleeding is acceptable.• Pregnancy is not an ideal time for a Pap smear, because it can give misleadingresults. However, if the woman is in the target age group and it is likely that shewill not return after giving birth, proceed with the smear.Use Practice Sheet 4 to give counselling before doing any examination,test or procedure. Counselling steps specific to taking smears are PS4included in the steps below.CounsellingPreparation1. Explain the procedure, what the test results mean, and whyit is important to return for the test results and act on themappropriately. Ensure that the woman has understood and obtaininformed consent.2. Do a speculum examination as described in Practice Sheet 7.PS6Informed consentPS7PS7 Pelvic examTaking the smear with a wooden spatula3. Insert the long tip of the spatula into the os, and rotate it through a full circle(360 degrees).Figure PS8.2 Taking a sample of cervical cells with a wooden spatula4. Smear both sides of the spatula onto the glass slide with one or two carefulswipes. If you see any abnormalities outside the area sampled, take a separatespecimen and smear it on another slide.