[Conisation during pregnancy (author's transl)]

Area of Science:

• Gynecologic Oncology
• Reproductive Medicine

Context:

• Conisation (cervical cone biopsy) is a surgical procedure to remove abnormal cervical tissue.
• Pregnancy presents unique challenges for managing cervical conditions.

Purpose:

• To review outcomes of conisation performed during pregnancy for cervical pre-invasive neoplasia and dysplasia.
• To evaluate the efficacy of conisation and prophylactic cerclage in preserving pregnancy.

Summary:

• Fifteen pregnant patients underwent conisation for cervical abnormalities, including pre-invasive carcinoma and high-grade dysplasia.
• Complete removal of atypical tissue was achieved in 6/8 superficial lesions but only 1/5 deep endocervical lesions.
• Conisation without cerclage resulted in abortion in 4/13 patients; prophylactic cerclage improved live birth rates and gestational age at delivery.

Impact:

• Highlights the challenges of achieving complete excision for endocervical lesions during pregnancy.
• Demonstrates the potential benefit of prophylactic cerclage in reducing pregnancy loss after conisation.
• Provides insights into managing cervical dysplasia in pregnant patients, balancing oncologic and obstetric outcomes.