title: Cervical cancer in pregnancy:  3 cases, 3 different approaches.
abstract: OBJECTIVE
  Cervical cancer is one of the most common malignancies in pregnancy and one percent of women diagnosed with cervical cancer are pregnant or postpartum at the time of the diagnosis. We discuss how pregnancy will affect the management of cancer, and cancer will affect the management of the pregnancy.
  
  
  METHODS
  Three case reports.
  
  
  RESULTS
  We report three cases, with three different approaches of pregnant patient with cervical carcinoma stage IB1, diagnosed below-20 weeks gestation. In two cases, the patients decided to continue the pregnancy.
  
  
  CONCLUSIONS
  Cervical cancer in pregnancy is a clinical challenge. Once the diagnosis, the stage and the extent of invasive cervical cancer have been established, a multidisciplinary approach is required. Decisions regarding timing of treatment and delivery require careful considerations, as well as the trimester in which the diagnosis is made. Delaying definitive treatment to improve fetal outcome, may carry an additional risk of tumor progression, although a delay in definitive treatment is regarded as feasible. Delayed treatment is safe in patients with small sized, early stage disease, if there is no evidence of disease progression. Neoadjuvant chemotherapy during pregnancy is still controversial. Cesarean delivery followed by radical hysterectomy is recommended. The effect of cervical cancer on pregnancy outcome is still not clear.
authors.affiliation: Maternity Dr. Alfredo da Costa. filipacribeiro@gmail.com
authors.forename: Filipa
authors.initials: F
authors.lastname: Ribeiro
authors.forename: Lúcia
authors.initials: L
authors.lastname: Correia
authors.forename: Tereza
authors.initials: T
authors.lastname: Paula
authors.forename: Isabel
authors.initials: I
authors.lastname: Santana
authors.forename: Luís
authors.initials: L
authors.lastname: Vieira Pinto
authors.forename: Jorge
authors.initials: J
authors.lastname: Borrego
authors.forename: Ana Francisca
authors.initials: AF
authors.lastname: Jorge
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D020360:Neoadjuvant Therapy / Q000379:methods*; D011247:Pregnancy; D011248:Pregnancy Complications / Q000175:diagnosis* / Q000473:pathology / Q000628:therapy*; D016896:Treatment Outcome; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis* / Q000473:pathology / Q000628:therapy*