Obstetric management following fertility-sparing radical vaginal trachelectomy for cervical cancer.
Radical vaginal trachelectomy now affords a fertility-sparing procedure for the treatment of early-stage cervical cancer in young women. Subsequent obstetric management within this group of women remains a challenge to the obstetrician, with risks of premature labour a continuing probability throughout pregnancy. Here we describe four cases of successful pregnancy following radical vaginal trachelectomy within our unit. The merits of early antenatal intervention, regular lower uterine segment length monitoring and use of daily progesterone pessaries are discussed, alongside the current supportive evidence. We conclude with a discussion of proposed recommendations for obstetric management of pregnancy in women post-radical vaginal trachelectomy.
Centre for Women's Health, Royal Devon and Exeter Hospital, Exeter, UK. lisaknight@doctors.org.uk
L J
LJ
Knight
N
N
Acheson
T A
TA
Kay
J N
JN
Renninson
J H
JH
Shepherd
M J O
MJ
Taylor
D000230:Adenocarcinoma / Q000601:surgery*; D000328:Adult; D002585:Cesarean Section; D005260:Female; D013509:Gynecologic Surgical Procedures / Q000009:adverse effects*; D006801:Humans; D008875:Middle Aged; D011247:Pregnancy; D011248:Pregnancy Complications / Q000209:etiology*; D002583:Uterine Cervical Neoplasms / Q000601:surgery*