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Invasive cervical cancer in pregnancy
D G Allen1, R S Planner, P T Tang
1Department of Obstetrics and Gynaecology, University of Melbourne, Victoria.
The Australian & New Zealand Journal of Obstetrics & Gynaecology
|November 1, 1995
Summary
Cervical cancer during pregnancy requires individualized management. Early Pap smears and conservative treatments like cone biopsy for microinvasive cases offer good outcomes for mother and baby.
Area of Science:
- Obstetrics and Gynecology
- Gynecologic Oncology
Background:
- Cervical cancer is the most common malignancy complicating pregnancy, yet its management is debated.
- Optimal strategies for maternal survival and live birth are sought.
Purpose of the Study:
- To review management options for cervical cancer diagnosed during pregnancy or postpartum.
- To identify effective strategies for long-term maternal survival and successful delivery.
Main Methods:
- Retrospective review of 22 cases of cervical cancer diagnosed between January 1981 and March 1995.
- Analysis of treatment modalities (cone biopsy, radical hysterectomy, radiotherapy, chemotherapy) and delivery methods.
Main Results:
- Incidence of cervical cancer in pregnancy was 0.26 per 1,000 pregnancies.
- Eleven patients had microinvasive disease, nine treated with cone biopsy.
- All 22 patients survived with only one recurrence; 20 delivered live babies.
Conclusions:
- Antenatal Pap smears are recommended for all pregnant women.
- Cone biopsy is a safe and potentially adequate treatment for microinvasive cervical cancer in pregnancy.
- Individualized treatment, including delivery timing, is crucial, with patient involvement in decision-making.