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Q. My pap is inflammatory with negative culture. Will it influence my chance of pregnancy?

Answered by
Dr. Jimesh H Mavani
and medically reviewed by Dr. Vinodhini. J
This is a premium question & answer published on Feb 29, 2020

Hello doctor,

I am a 34-year-old woman. I have a 3-year-old son and I have been trying to conceive my second child with no success during the past several months.

During the pregnancy with my son, I had a cervical cerclage placed, which was not removed at the cesarean section (the doctor forgot). The cerclage got infected three months later after birth when resuming sexual activity. I went to a different doctor who removed the cerclage and gave me a course of Augmentin antibiotic. I had no more infection. However, during my period I would perceive a vague fishy smell of the blood. No other smell during any other time of the cycle. I had multiple cervical and vaginal cultures done (including mycoplasma, ureaplasma, gonorrhea, chlamydia) and everything is always negative. My PAP tests are also normal but show non-specific reactive inflammation.

I was given Doxycycline and Metronidazole for 14 days and I also took Cephalexin for seven days during this month for a UTI. However, when repeating the pap and cultures last week, it is still inflammatory with negative cultures.

I am also scheduled for a sonohisterosalpingography this week. Can this procedure be done when I have an inflammatory pap considering cultures are negative and the pap is still inflammatory despite antibiotic treatment? Is it safe?

Can the inflammation be related to the cerclage somehow? Or can it show in fact some cervical cancer or dysplasia? And if there are precancerous changes in the cells of the cervix (although the pap did not say that) could the sono-HSG actually push them into the uterus and ovaries and possibly cause cancer there? Or am I over reacting?

I need to mention my paps were always normal before the pregnancy and the cerclage situation. I am worried and do not know what to do.

Dr. Jimesh H Mavani

General Practitioner Obstetrics And Gynaecology
#

Hi,

Welcome to icliniq.com.

Do not think much. If you have a negative culture and you had course of antibiotics after an inflammatory pap test then, mostly infection or active insects are removed from the cervix.

Now in hysterosalpingography dye is pushed inside the uterus and two or three x-rays are taken for tubal patency. And along with that many times, doctor prescribes one antibiotics course as a precaution for prophylaxis against infection. Inflammation can be chronic, can be post-delivery, or age-related. But do not worry if you have taken antibiotics already.

Secondly, hysterosalpingography is mostly prescribed to see the tubal patency to rule out any problem related to fallopian tubes. So it is a safe procedure do not worry.

I hope this helps.


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