Cervical Cancer in Pregnancy

Abstract

Cervical cancer in pregnancy is a clinical challenge. Once the diagnosis, the stage and the extent of invasive cervical cancer have been established, a multidisciplinary approach is required. Decisions regarding timing of treatment and delivery require careful considerations, as well as the trimester in which the diagnosis is made. Delaying definitive treatment to improve fetal outcome, may carry an additional risk of tumor progression, although a delay in definitive treatment is regarded as feasible. Delayed treatment is safe in patients with small sized, early stage disease, if there is no evidence of disease progression. Neoadjuvant chemotherapy during pregnancy is still controversial. Cesarean delivery followed by radical hysterectomy is recommended. The effect of cervical cancer on pregnancy outcome is still not clear.

Peripartum Hysterectomy

“…An elective PH may be performed if abnormal placentation is diagnosed in the antepartum period. Occasionally pregnant women with stage IA2 and IB1 cervical carcinoma are candidates for an elective PH [11]. Severe postpartum infection unresponsive to medical therapy and placental site vessel subinvolution is other potential indications for elective PH [11][12][13].…”

“…Occasionally pregnant women with stage IA2 and IB1 cervical carcinoma are candidates for an elective PH [11]. Severe postpartum infection unresponsive to medical therapy and placental site vessel subinvolution is other potential indications for elective PH [11][12][13]. Also, giving birth with cesarean section is associated with a fourfold risk compared to vaginal delivery [14].…”