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Conventional Pap-Vaginal Smear
DES Exposure

Indications: Evaluation of potential changes associated with in utero DES exposure.

Specimens required: Lateral vaginal wall sample, cervical sample, endocervical sample.

Supplies: Vaginal speculum, one or more cervical spatulas, one extended-tip spatula, cytobrush, fixative (spray fixative or 95% ethanol), two or more clean glass slides (single end frosted), black lead lab pencil, and test request form. Pap kits are available from PLA.

Collection procedures:
a) Label two slides with patient’s first and last name, date of birth and specimen source.
b) Label one slide “C” and one “LVW”. Label others as necessary (see below).
c) Obtain specimens prior to bimanual examination. Use an un-lubricated speculum (saline or warm water may be used). After visualization of the upper 1/3 of the vagina is accomplished use the spatula to scrape the upper 1/3 of either lateral vaginal wall. Withdraw the spatula and spread the material quickly and evenly onto the slide clearly marked “LVW.”
d) Fix immediately (drop slide into fixative or spray with fixative holding the spray bottle approximately 10-12 inches from the slide).
e) Scrape additional areas of the vagina that appear abnormal. Label slides accordingly (prior to sampling) and spread and fix as above.
f) Obtain routine cervical and endocervical specimens as outlined in the respective procedures. These smears should be collected on the slide labeled “C.” Complete the Cytology test request form, including relevant history. Submit the specimen to the Cytopathology Laboratory.

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