ANSC Newsletter October 2019
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Antenatal Shared Care Update
October 2019
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My patient is pregnant. Should I offer her a cervical screening test? – Cervical screening can be carried out safely at any time during pregnancy.
If your patient is due or overdue for cervical screening or has never had cervical screening and is over 25, you can offer a cervical screening test at any time during her pregnancy.
Women who are due or overdue for screening should be screened. For some women, pregnancy may be the first opportunity for cervical screening and cervical cancer is more likely to be diagnosed in never screened or under-screened women.
The guidelines state:
“If a patient is due for screening, screening can be carried out safely at any time provided that the correct equipment is used”.
Click here to view Screening in pregnancy: Cancer Council Clinical Guidelines Network.
Points to remember:
- Routine antenatal and postpartum care should include a review of the patient’s cervical screening history.
- Offer a cervical screening test at any stage of a patient’s antenatal care.
- Advise the patient that cervical screening is safe during pregnancy.
- Advise the patient that vaginal spotting may occur after the procedure, poses no risk to the pregnancy and is self-limiting.
- The Cyto-broom is recommended for pregnant patients to collect a cervical screening specimen. The endocervical brush is not recommended.
- Self-collection is not recommended in pregnancy.
- Some patients may wish to defer their cervical screening test until after they give birth, advise them the screening test will be recommended again at the postnatal visit.
What about cervical screening after the birth?
Early pregnancy, when a woman is being examined for matters relating to her pregnancy is a good time to offer a cervical screening test. It can be hard for women to make time for their own health after their baby is born, so it may be preferable to have the test done before the baby's arrival.
If a woman has chosen to defer her cervical screening test until after she has given birth, it is best to wait at least six weeks and ideal to wait three months. If a screening test is performed too soon after the delivery, there is an increased rate of unsatisfactory results.
Click here for consumer information about cervical screening.
Requiring an interpreter?
A free telephone 24-hour interpreting service is available for medical practitioners in private practice. For more information or to register for the Doctor’s Priority Line contact TIS National on 1300 575 847 OR Call TIS National on 131 450.
Syphilis in pregnancy – testing and management
NSW Health has recently released an information alert focusing on testing and management of syphilis in pregnancy, primarily for primary care practitioners in the context of increasing notifications of syphilis in females.
Key points
1. Screen all pregnant women for syphilis early in gestation
2. Screen pregnant women considered at increased risk of an STI again at 24-28 weeks
3. Treat all pregnant women with syphilis urgently
4. Contact local sexual health clinic or public health unit for advice and assistance
NSW Sexual Health Info Link ph. 1800 451 624; Public Health Unit ph. 1300 066 055
Click here for further details regarding alert information
For feedback or program enquiries please contact Maternal Health Program Officer:
Karen Wheeler (RPA and Canterbury)
k.wheeler@cesphn.com.au 1300 986 991
Jane Miller (RHW and St George/Sutherland)
j.miller@cesphn.com.au 1300 986 991