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I'm confused about an irregular pap smear and follow up test.

I'm 42 and recently gave birth to twins.  I've been married 11 years, and the twins are our 3rd and 4th children.  For the first two, my pap smear tests were clean.

This time, my 16 week pap smear indicated "cells of inconclusive origin."  I have had one sexual partner (my husband), and he's had two.  He's always been honest, and his other partner was a drunken college hookup.  They did use condoms.

Now, at my first checkup, the midwife did another pap smear and talked about me having HPV.  I told my husband, and he's crushed.

The midwife was different than the one who presented the inconclusive results months earlier.  I have not had an HPV test since then.  So is the midwife assuming I have HPV, and that's why she ordered another test?  If I did have HPV for sure, wouldn't the referral be straight to a coloscopy?


To clarify the timeline.  Husband has protected sex in college in 2002.  We get married in 2010, have kids in 2011 and 2013 with normal pap smears.  2019 pregnancy results in "cells of unknown origin."  The test I had yesterday had to be the actual HPV test, correct?
3 Responses
207091 tn?1337709493
I would be really surprised if you had HPV. My guess, and it's a guess, is that your midwife is assuming the "cells of unknown origin" are HPV, without any real evidence.

She is smart to do the HPV test - that's a good next step, if that's what she did. Was it a culture where she used a swab on your cervix?

They see tons of women, and to be fair to them, most "cells of unknown origin" probably end up being HPV. It's estimated that 90% of sexually active people will get it at least once in their lifetimes.

You and your husband are not high risk, and some of these steps will just be standard protocol.

HPV clears itself from the body within 2 years in about 90% of those infected. Others can take longer. However, given that your husband is your only partner, and his last partner other than you was 17 years ago, and it was protected, I'd be very surprised if this is HPV. (It's possible to get HPV while using a condom, but it reduces the chances a lot, and given that, and how long it's been, combined with all your other normal paps, I'd be surprised.)

Let us know what happens.
973741 tn?1342342773
COMMUNITY LEADER
I agree.  My guess too is that it was an assumption that HPV was involved.  They could be Atypical Squamous Cells of Undetermined Significance or ASCUS.  Those can occur due to something as simple as inflammation or infection.  But ya, HPV causes them too.  However, abnormal cells found could also be precancerous and would need to be removed.  I'd want them examined further personally and frozen off.  
Avatar universal
Lab results came back today....all negative.  So my "abnormal cells" were from many of the other reasons that could have caused them.  This is the same midwife practice that noted 10th-15th percentile femur lengths for our twin girls at 35 weeks....but never told us why.  Which caused us both to irrationally worry about DS (we did not do any early testing, and would take/love whatever we got!), but still!  

Anyway, thank you for the thoughtful, logical answer.  You were spot on!
3 Comments
That's great news!  What are they planning to do for the spots?  Just watch?  
Great news!

Are you getting another pap in 3 months? 6 months?

And maybe time for a new care provider? She seems to cause more worry than may be needed.
Glad to hear everything checked out fine. There are many things that are relatively harmless that can cause abnormal paps. So oftentimes there is no need for colposcopy or removal of any tissue. I had one abnormal pap and was told to return for another in 6 months or so.
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