Authors: Nanako Iwami Shinichi Ishioka Toshiaki Endo Tsuyoshi Baba Kunihiko Nagasawa Madoka Takahashi Asuka Sugio Sakura Takada Tasuku Mariya Masahiro Mizunuma Tsuyoshi Saito
Publish Date: 2011/03/18
Volume: 16, Issue: 6, Pages: 737-740
Abstract
A diagnosis of cervical cancer during pregnancy poses difficult management and ethical problems Survival of the patient is the foremost concern but fetal viability and wellbeing must also be addressed Radical trachelectomy RT has recently begun to be performed as a possible treatment modality for early stage invasive uterine cervical cancer in pregnant patients who would like to continue their pregnancy A 32yearold Japanese woman visited a local hospital for prenatal care and was diagnosed with a FIGO I B1 adenocarcinoma of the uterine cervix She had a strong desire to avoid pregnancy termination so she was admitted to our hospital for fertilitypreserving surgery After extensive counseling vaginal radical trachelectomy with abdominal pelvic lymphadenectomy was performed in the 16th gestational week The excised uterine cervix and lymph nodes were pathologically negative for cancer To maintain her pregnancy daily vaginal disinfection with povidone iodine bed rest and administration of ritodrine and an ulinastatin vaginal suppository were continued until the delivery At 34 weeks’ gestation an emergency cesarean section was performed because of sudden premature rupture of the membranes A baby girl was born weighing 2112 g with Apgar score of 8/9 The mother remains without evidence of recurrence at the time of this report This is the first case of successful pregnancy and delivery in Japan after vaginal RT
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