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General
- Using a pencil label the slide
with the woman's surname, given name and D.O.B.
- Complete the request form, paying particular attention
to the woman’s personal identification details.
- Lubricate the speculum with warm water, not with creams
or jellies.
- Visualise the cervix.
Spatula
- Place the end of the spatula in
the cervical os, as shown in the diagram.
- Rotate the spatula twice through
360° keeping the shoulder of the spatula in contact with
the ectocervix.
- Hold the slide by the frosted end
and smear both sides of the spatula onto one half of the
slide, then quickly obtain the brush sample.
Endocervical Brush
- Rotate the endocervical brush
gently in the endocervical canal (through one quarter
rotation only), leaving the lower three rows of bristles
visible.
- Remove the brush and roll it quickly but gently onto the
unused half of the slide.
Do not use an endocervical brush if the woman is pregnant.
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CERVEX
SAMPLER
- Place the tip of the Cervex Sampler in
the endocervical
canal as shown in the diagram.
- Rotate several times, keeping the bristles in contact
with the ectocervix.
- Hold the slide by the frosted end and
sweep one side of
the Sampler down the slide. Quickly turn the Sampler over
and repeat as illustrated.
- Always ensure you sample the
squamo-columnar junction. If
there is a large eversion, take care to sample the periphery
of the eversion with the spatula or Sampler.
What Next?
- Immediately spray the whole of the
slide with fixative from a distance of at least 25cm (10
inches).
- Allow to dry. Place slide in the
slide carrier. Put the slide carrier and the request form
in the plastic bag and send to VCS.
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THE SQUAMO-COLUMNAR JUNCTION
The Squamo-Columar Junction – the area to sample when taking
a smear
The vagina is lined by multi-layered squamous cell epithelium (S1),
whereas the endocervix is lined with single-cell mucus-producing
columnar epithelium (G). The columnar epithelium meets the squamous
epithelium at the squamo-columnar junction (SCJ).
During the normal course of a woman’s life the columnar epithelium
changes or transforms into squamous epithelium: this area is thus
known as the transformation zone (TZ—here illustrated as S2).
It is at the TZ that squamous cell carcinoma of the cervix is believed
to arise. This is therefore the area to be targeted when taking
a Pap smear.
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