Diagnosis and treatment of cervical cancer during pregnancy.
OBJECTIVE
One third of all cervical carcinomas occur during the reproductive period. Cervical carcinoma is the second greatest cause of death due to cancer during this phase. The estimated frequency of cervical cancer during pregnancy is one case for every 1,000 to 5,000 pregnancies. The aim here was to provide information about the difficulties in diagnosing and managing cervical neoplasia during pregnancy.


METHODS
A systematic review of the literature was undertaken through the PubMed, Cochrane, Excerpta Medica (Embase), Literatura Latino Americana e do Caribe em Ciências da Saúde (Lilacs) and Scientific Electronic Library Online (SciELO) databases, using the following words: pregnancy, cervical cancer, diagnosis and management.


RESULTS
There was a consensus in the literature regarding diagnosis of cervical carcinoma and management of preneoplastic lesions during pregnancy. However, for management of invasive carcinoma, there was great divergence regarding the gestational age taken as the limit for observation rather than immediate treatment.


CONCLUSIONS
All patients with cytological abnormalities should undergo colposcopy, which will indicate and guide biopsy. Conization is reserved for patients with suspected invasion. High-grade lesions should be monitored during pregnancy and reevaluated after delivery. In cases of invasive carcinoma detected up to the 12th week of pregnancy, patient treatment is prioritized. Regarding diagnoses made during the second trimester, fetal pulmonary maturity can be awaited, and the use of chemotherapy to stabilize the disease until the time of delivery appears to be viable.
Gonçalves
Carla Vitola
CV
Mother-Child Department, Universidade Federal do Rio Grande, Rio Grande, Rio Grande do Sul, Brazil. carlavg@brturbo.com.br
Duarte
Geraldo
G
Costa
Juvenal Soares Dias da
JS
Marcolin
Alessandra Cristina
AC
Bianchi
Mônia Steigleder
MS
Dias
Daison
D
Lima
Luis Cláudio de Velleca e
LC
D002294:Carcinoma, Squamous Cell / Q000175:diagnosis / Q000628:therapy; D005260:Female; D005865:Gestational Age; D006801:Humans; D009367:Neoplasm Staging; D011247:Pregnancy; D011252:Pregnancy Complications, Neoplastic / Q000175:diagnosis / Q000628:therapy; D011264:Pregnancy Trimesters; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis / Q000628:therapy