Papanicolaou smear adequacy: effect of different techniques in specific fertility states.

Six hundred fifty-four Papanicolaou smears were studied prospectively to determine the yield of endocervical cells within specific fertility states by technique used. Smears from postmenopausal women had the lowest yield of endocervical cells (32 percent, P less than 0.01). Smears from postpartum women had a higher yield of endocervical cells than those from pregnant women (69 percent vs 59 percent, P greater than .05). Swabbing excess mucus from the cervix prior to scraping uniformly improved the yield of endocervical cells (70 percent vs 62 percent, P less than .02). In swabbed postmenopausal women, use of a Milex spatula had a significantly higher yield than the use of a wooden spatula and a cotton-tipped applicator (43 percent vs 27 percent, P less than .03).