Should a nylon brush be used for Pap smears from pregnant women?

Abstract

Use of a nylon brush (Cytobrush and others) with spatula to obtain Papanicolaou (Pap) smears from pregnant women is more likely to obtain sufficient endocervical cells, without adverse consequence for the mother or for the fetus. This method is also most likely to be cost-effective. However, current evidence does not support any superiority of the nylon brush with spatula for any patient-oriented outcomes (eg, fewer procedures, less cancer, etc) during or after pregnancy (strength of recommendation: A; based on multiple randomized controlled trials).