Frosted end, clean glass slide
Special Patient Preparation Requirements
- The patient should not have applied any
intravaginal douches or therapy during the 24 hours prior to the
- Materials needed:
- A clean glass slide labeled with the
patient's name (patient's name should be written with a
- Ayre spatula.
- Cervical brush (or "broom") as
- Non-aerosol (pump) spray fixative.
- Place the patient in the lithotomy position.
- Insert the speculum without lubricants (just
warm tap water).
- The posterior vaginal fornix (pool) and the
ectocervix are typically sampled with a wooden tongue depressor or
Ayre spatula. Insert the spatula into the cervix. Using the rounded
end of the instrument, a scraping is obtained from the posterior
vaginal fornix with the material kept on the instrument .
Then a scraping with the second spatula is made from the ectocervix
by rotating the spatula 360 degrees in an effort to obtain thorough
sampling of the transformation zone. Again the material is kept on
Finally the endocervical sample is obtained using a commercially
available endocervical brush. The latter is not necessarily utilized
in the pregnant patient.
All of the samples must then be swiftly transferred to a labeled
slide. Immediately fix the smear by spraying fixative held
10-12 inches away from the slide. This must be done as quickly as
possible to avoid air drying, which will hinder the cytologic
- "Broom": Another collection
instrument for Pap smears is a plastic "broom-like" brush
which simultaneously samples the endocervix and ectocervix.
To use the broom, the long central bristles are inserted into the
cervical os until the lateral bristles bend against the ectocervix.
Rotate 3-5 times in clockwise and counter-clockwise directions. To
transfer material, both sides of the "broom" are brushed
across the glass slide.
Use of a cotton-tip applicator is not recommended; it provides less
cellular samples due to material being trapped in the fibers.
As indicated above, immediately fix the smears
by spraying with fixative, held 10-12 inches away from the slide. Any
air-drying will hinder the cytologic interpretation.