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Cervical Cancer in Pregnancy: 3 Cases, 3 Different Approaches

Ribeiro, Filipa MD1; Correia, Lúcia MD1; Paula, Tereza MD1; Santana, Isabel MD2; Vieira Pinto, Luís MD2; Borrego, Jorge MD1; Jorge, Ana Francisca MD2

Journal of Lower Genital Tract Disease: January 2013 - Volume 17 - Issue 1 - p 66–70
doi: 10.1097/LGT.0b013e31824d6fb8
Original Articles

Objective: Cervical cancer is one of the most common malignancies in pregnancy and one percent of women diagnosed with cervical cancer are pregnant or postpartum at the time of the diagnosis. We discuss how pregnancy will affect the management of cancer, and cancer will affect the management of the pregnancy.

Material and Methods: Three case reports.

Results: We report three cases, with three different approaches of pregnant patient with cervical carcinoma stage IB1, diagnosed below-20 weeks gestation. In two cases, the patients decided to continue the pregnancy.

Conclusions: 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.

In early-stage cervical cancer diagnosed in the first half of pregnancy, a delaying treatment can be proposed under strict conditions.

1Maternity Dr. Alfredo da Costa; and 2Francisco Gentil Portuguese Institute of Oncology, Lisbon, Portugal

Correspondence to: Filipa Ribeiro, MD, R. João Apolinário 8A-3°B, 2795-207 Linda-a-Velha, Portugal. E-mail: filipacribeiro@gmail.com

The authors declare they have nothing to disclose.

©2013The American Society for Colposcopy and Cervical Pathology