Cervical Screening & HPV (incl. vaccination)
Admission & discharge
Admission/discharge guidance checked 2026-10-18 against the linked sources. This is a clinical checklist for an individual decision, not an automatic discharge order.
When admission or continued hospital care is needed
- Uncontrolled bleeding, severe pain, infection concern, an anaesthetic complication or suspected invasive cancer with acute complications requires assessment/admission as indicated.
When clinic, day care or home care may be suitable
- HPV positivity, screening abnormalities and uncomplicated colposcopy/biopsy are normally managed without admission. Ensure abnormal results reach the colposcopy pathway.
Before going home
- After biopsy/treatment, bleeding and pain are controlled and the patient understands what was done, expected symptoms and who communicates results.
Discharge medicines and treatment changes
- Provide only the indicated analgesia or other procedure-specific prescription; routine HPV positivity is not an indication for antibiotics.
Medicine doses — use only when indicated
Use the medicines selected for this patient. Listed alternatives are not instructions to prescribe all of them together. Confirm the actual remaining course, pregnancy/postnatal context and monitoring plan.
Short-term pain relief when appropriate after the procedure.
- Indication: Short-term maternal postoperative/postpartum pain or other mild pain after assessment; adult ≥50 kg
- MSF oral monograph: no pregnancy or breastfeeding contraindication. The dose does not replace assessment of the cause of pain.
- Pain and functional recovery; investigate increasing pain, fever or other warning symptoms.
- Check all prescribed/OTC paracetamol, weight and hepatic risk; suspected excess dosing requires urgent assessment.
Tests, pending results and their reviewer
- Record biopsy/histology and screening follow-up ownership; a missed result is not an acceptable discharge endpoint.
Home care and counselling
- Give the exact bleeding, vaginal-product/sex and activity advice for biopsy versus LLETZ or another treatment; instructions differ by procedure.
Follow-up: when and what to review
| When | Action / responsible service |
|---|---|
At the stated histology/results date | Review and communicate results, with a fallback contact if no result arrives. |
At the booked screening/colposcopy interval | Complete recommended surveillance or treatment; new symptoms need assessment sooner. |
Return urgently
- Heavy bleeding, offensive discharge, fever or severe/worsening pelvic pain needs prompt assessment.
Treatment
① Immediate stabilization — first minutes
③ First-line treatment & drug regimens
| Result context | Action |
|---|---|
Normal cytology/HPV-negative | Routine re-screening interval per programme |
HPV+ with abnormal cytology / LSIL etc. | Colposcopy-directed biopsies |
CIN1 | Observe + repeat testing 12 m (regression common) |
CIN2+ (treatable) | Excisional treatment LLETZ/LEEP preferred (histology-complete); cold-knife cone selected cases |
Glandular abnormalities | Diagnostic excision always |
Pregnancy | Colposcopy safe; treatment deferred to postpartum unless invasive suspicion |
Definitive treatment
Excisional treatment clears CIN2+ in ~90-95%; follow-up co-testing schedules mandatory post-treatment.
Monitoring
- Post-LLETZ HPV test-of-cure at 6-18 m per programme
⑮ Complications & their management
Post-excision bleeding/infection
Silver nitrate/vaginal packing; antibiotics if infected
Preterm-birth risk after excision depth
Documented depth; cervical-length surveillance next pregnancy
Post-treatment care
- Screening continues post-treatment per schedule even after vaccine
Diagnosis & assessment
Sources (8)
2021-07 · updated 2025-12-22 (page review; guidance itself unchanged) · checked 2026-08-23 · verified-live
Open source ↗
CDC pages + wall chart: uncomplicated gonorrhoea cervix/urethra/rectum → ceftriaxone 500 mg IM single dose (<150 kg; 1 g if ≥150 kg); pharyngeal same; conjunctivitis 1 g IM; DGI 1 g IV/IM q24h; PID outpatient → ceftriaxone 500 mg IM ×1 + doxycycline 100 BD ×14 d + metronidazole 500 BD ×14 d; chlamyd…
· checked 2026-10-18 · verified-live
Open source ↗
Primary full page read: usual home recovery, expected bleeding/discharge, restrictions during recovery, heavy bleeding/offensive discharge/persistent pain and tracking biopsy results.
· checked 2026-10-18 · verified-live
Open source ↗
Full primary oral monograph read: adult 1 g 3–4 times daily, maximum 4 g/day, ≥50 kg adult table, 500 mg tablets, duration according to response, hepatic caution and pregnancy/breastfeeding. Pain chapter also checked for 6–8-hour interval. Smaller adults require an individual weight-based prescripti…
· checked 2026-10-18 · verified-live
Open source ↗
Maternal/newborn transfer assessment, first void and effective feeding, handover, support/safeguarding, first midwife visit within 36 hours after transfer, postnatal danger symptoms. Full recommendations page read.
· checked 2026-10-18 · verified-live
Open source ↗
Normal-delivery discharge not less than 48 hours: full primary SOP PDF normal-delivery/discharge passages read. Corroborated by NHM CEmONC 2024 Part 1, chapter 8. This does not define a universal post-caesarean or complicated-case stay.
· checked 2026-10-18 · verified-live
Open source ↗
Official WHO summary read: at least 24-hour facility care after birth; additional contacts at 48–72 hours, 7–14 days and week 6; individual assessment/support. Summary facts only, not a claim that the full 242-page PDF was reviewed.
· checked 2026-10-18 · verified-live
Open source ↗
Full primary patient recovery page read: pain control, wounds, activity/VTE, urinary/bowel and infection warning signs, adult support and no driving/important decisions during the first 24 hours after general anaesthesia. Used as general recovery/handover principles, not operation-specific discharge…
· checked 2026-10-18 · verified-live
Open source ↗
Full primary recommendations read, focusing on critical-care-to-ward transfer: structured written handover, shared plan, monitoring, rehabilitation and receiving-team capability. Step-down is distinct from home discharge; no universal organ-support discharge cutoff is asserted.