Invasive cervical carcinoma in pregnant women: the authors’ own experience
Cervical cancer is one of the most commonly diagnosed malignant tumors in pregnant women. The existing current standards of therapy for invasive cervical carcinoma during pregnancy include surgery and/or chemotherapy. The tactics for treating patients is determined by gestational age, stage of disease, and a woman’s desire to maintain her pregnancy.Dobrokhotova Yu.E., Danelyan S.Zh., Borovkova E.I., Arutyunyan A.M., Khertek S.E.
Objective. To generalize and analyze the authors’ own experience in managing pregnant women with invasive cervical carcinoma.
Subjects and methods. Sixteen cases of invasive cervical carcinoma were retrospectively analyzed in pregnant women with a median age of 34.5 years; the period of initial diagnosis was 21.6 weeks.
Results. Pregnancy was complicated by threatened miscarriage in the first trimester in 18.75% of cases; atypical conization was performed in 25%; 2 (12.5%) patients received neoadjuvant chemotherapy. Delivery at term occurred in 62.5% of patients, preterm delivery in 31.2%. The median gestational age at delivery was 36.3 weeks. Cesarean section was performed in 68.7%. Wertheim’s operation following cesarean section was made in 7 (43.7%) patients and with ovarian transposition in 57%. The weight of newborn babies was 3025±312 g. Within 1 year after their birth, the infants developed according to age norms.
Conclusion. Due to the introduction of clinical protocols into practice, since 2019 material should be collected from the cervix uteri for cytological examination from all pregnant women when registered at a women’s health center. Compliance with the rules for the collection and transportation of cytological material, as well as its careful interpretation, is the key to the timely identification of patients at risk for cervical cancer. Additional examination of these patients, by carrying out tests for human papillomavirus and colposcopy, and, if necessary, targeted colposcopic biopsy will be able to reduce the frequency of late diagnosis of cervical cancer.
Keywords
invasive cervical carcinoma
pregnancy
chemotherapy
staging
cesarean section
Wertheim’s operation
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Received 12.05.2020
Accepted 30.10.2020
About the Authors
Yulia E. Dobrokhotova, MD, Professor, Head of Department of Obstetrics and Gynecology, Faculty of General Medicine, N.I. Pirogov Russian National Research Medical University. Tel: +7(495)722-6399. E-mail: pr.dobrohotova@mail.ru. 1-9, Ostrovityanova str., Moscow, 117997, Russia.Sonia Zh. Danelyan, PhD, Deputy Chief Physician for Obstetrics and Gynecology, City Clinical Hospital No. 40, Moscow.
Tel.: +7(495)470-10-01. E-mail: gkb40-rd@zdrav.mos.ru. ORCID: 0000-0002-8594-6406. 6, Taimyrskaya str., Moscow, 129336, Russia.
Ekaterina I. Borovkova, MD, Associate Professor, Professor of Therapeutical Faculty, Obstetrics and Gynecology Department, N.I. Pirogov Russian National Research Medical University. Tel: +7(903)785-5793. E-mail: Katyanikitina@mail.ru. 1-9, Ostrovityanova str., Moscow, 117997, Russia.
Anna M. Arutyunyan, post-graduate student of the Department of Obstetrics and Gynecology, Faculty of General Medicine, N.I. Pirogov Russian National Research Medical University. Tel: +7(916)697-05-54. E-mail: annochka21.90@mail.ru. ORCID: 0000-0002-6392-5444. 1-9, Ostrovityanova str., Moscow, 117997, Russia.
Snezhana E. Hertek, Clinical Resident, Department of Obstetrics and Gynecology, Faculty of General Medicine, N.I. Pirogov Russian National Research Medical University. Tel.: +7 (923)383-50-07. E-mail: cnejano4ka@mail.ru. ORCID: 0000-0002-2172-0803. 1-9, Ostrovityanova str., Moscow, 117997, Russia.
For citation: Dobrokhotova Yu.E., Danelyan S.Zh., Borovkova E.I., Arutyunyan A.M., Khertek S.E. Invasive cervical carcinoma in pregnant women: the authors’ own experience.
Akusherstvo i Ginekologiya/Obstetrics and Gynecology. 2021; 1: 156-163 (in Russian)
https://dx.doi.org/10.18565/aig.2021.1.156-163
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