Every woman has her own pattern or distribution of cervix mucosal epithelium. At birth, the connections between the intrinsic squamous epithelium covering the vaginal opening and the intrinsic columnar epithelium along the cervical opening are not at the same level. Pregnancy, hormonal changes after puberty, vaginal pH, menopause, and prior therapy, in addition to individual anatomy, are factors that cause the exposed endocervical "zone" to gradually change or "transform."

Please Prepare Enough Samples: The transformation zone is where the majority of all squamous epithelial abnormalities (cancerous and precancerous) of the cervix occur. The transformation zone (rather than the endocervix above it) is the primary target for representative cervix sampling using the Pap technique. Atypicality may develop within the area, such as mildly abnormal "atypical squamous cells of undetermined significance" or progression to "low-grade squamous intraepithelial lesions" or "high-grade squamous intraepithelial lesions". The adequacy of the technique used is directly affected by the type of cervix being examined.

The specific sampling instruments (see below) and the sampling technique used should be based on the individual patient's anatomy, with particular attention to the location and configuration of the conversion zone. Sampling instruments include the Cervical Spatula, Pap Smear Brush, and broom (papette).

INSTRUCTIONS

Conventional Pap Smear Collection:

1.With the specimen face-up, hold the spatula between the fingers of the non-sampling hand while the cervical brush material is collected without delay.

2.Twirl the handle of the brush to move it across the slide. To avoid air-drying artifacts, transfer the material from both sampling instruments to the slide in a few seconds and fix IMMEDIATELY.

3.Tighten the vial cap and place all materials (including any slides in plastic slide holders) in a biohazard bag with a properly completed Gyn requisition. CONVENTIONAL SMEARS FIXATION Smears should be treated right away with a pump spray fixative or 95 percent alcohol. Prior to fixation, even a few minutes of air drying should be avoided. When using a spray, keep it 15-25cm away from the slide. Allow 10 minutes for it to dry after spraying before inserting it into plastic slide holders.Smears can also be fixed in 95% alcohol for 20 minutes, then removed, dried and placed in a plastic slide holder.