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Smears and coils

120 Posts

Posted:  07-Nov-2014 18:53
Hi all
Womdering if could ask a bit of advice. Just recently passed cervical screening course. Had a smear today pt had a copper coil in situ (only had 2 other pts with coils). At first i could see one string but after taking the sample i could no longer see the string. I was worried id pulled it out somehow but cant see how i would not notice this. However, still checkd in the pot and only cervical brush head in there!
Could i have moved the coil? Have i taken the sample wrong? Is there a certain way smears should be taken when coil insitu? (Never got one when mentor was present) Or can this just happen?
Spoke with gp who said its fine but im not too sure he really knows much about this sort of thing.
Do i need to be tellin the pt to do anything?

375 Posts

Posted:  07-Nov-2014 19:02
Hi Leanne

Firstly, congratulations on passing your course. Secondly, don't panic.

If a lady has a coil, I take a bit longer taking the sample to avoid the brush getting tangled up with the threads and possibly then pulling it out. It sounds as if the coiL threads may have retracted a bit. They may come down again by themselves or they may need a helping hand when it comes to removing the coil. I'm sure the others will correct me if I'm wrong, but I think you can use a Spencer Wells to gently run around the entrance of cervix to see if you can free the threads.

Does the pt normally check her threads? If she is worried that she can't feel them, it may be worth trying to find the threads, but otherwise, I'm not sure I'd worry too much about it as if you had pulled it out, you would have seen it for sure.

419 Posts

Posted:  07-Nov-2014 20:29
I personally wouldn't go fishing around to try and find threads. Most patients don't check their coil strings anyway and main risk of coil moving is in the initial period after insertion I believe. If it had come out you would have noticed so I would just leave it until next time they have smear or coil out and then cross that bridge !
Don't panic, all fine I'm would think !

523 Posts

Posted:  07-Nov-2014 21:18
I agree that sometimes as you do the rotations you can sometimes push the strings higher into the os, slowing down with the rotations can help but if the strings are short there is not a lot you can do

Hanging on in there
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