SAFETY, EFFICACY AND COST OF 3 CERVICAL CYTOLOGY SAMPLING DEVICES IN A PRENATAL CLINIC

OBJECTIVE: To evaluate and compare the safety, efficacy and cost of th ree cervical cytology sampling devices in pregnant women presenting fo r prenatal care to the obstetrics clinic, at Medical College of Pennsy lvania Hospital. STUDY DESIGN: from September 7, 1993, to November 5, 1993, 61 cervical cytologic smears were obtained using the Cell-Sweep. From November 8, 1993, to January 7, 1994, 66 smears were obtained us ing the Ayre spatula/Cytobrush, and from January 10, 1994, to February 18, 1994, 55 smears were obtained using the Ayre spatula/cotton swab. The rate of smears with no endocervical component or with epithelial cell abnormality was determined for each group. The patients' medical records were reviewed retrospectively to determine complications occur ring within two weeks of smear collection. RESULTS: Fifteen (25%) smea rs in the Cell-Sweep group, one (1.5%) in the Cytobrush group and nine (16%) in the cotton swab group were satisfactory but limited by absen ce of an endocervical component (P <.0006). None of the smears were un satisfactory. Eleven (18%) smears in the Cell-Sweep group, eight (12%) in the Cytobrush group and nine (16%) in the cotton swab group reveal ed an epithelial cell abnormality (P=.643). For all three groups there was a low rate of spontaneous abortion, preterm spontaneous rupture o f membranes or preterm labor occurring within two weeks of collection. There was no statistically significant difference in these complicati ons between the three groups (P=.7). The Ayre spatula/cotton swab is t he least expensive device. CONCLUSION: The Ayre spatula/cotton swab wa s the most satisfactory of the three methods tested for obtaining cerv ical cytology during pregnancy. It is safe and cost-effective and iden tifies the same proportion of epithelial cell abnormalities as the Ayr e spatula/Cytobrush and the Cell-Sweep.