title: Neonatal outcome in infants of patients with radical vaginal  trachelectomy.
abstract: OBJECTIVE
  Radical vaginal trachelectomy (RVT) as a fertility-preserving surgery in patients with early-stage cervical cancer is proven to be oncologically safe. After RVT, pregnancy rates vary between 40 % and 80 %. Outcome of infants is complicated by a preterm delivery rate of 30 – 50 %. We investigated pregnancy and neonatal outcome after RVT.
  
  
  METHODS
  A total of 154 patients with cervical cancer underwent RVT between March 1995 and February 2008. Desire to conceive, pregnancy data, and neonatal outcome were prospectively recorded. Infants’ data were pair-matched to data of a control group according to weeks of gestation. Bayley scales of infant development scores were recorded in the group of preterm-delivered infants.
  
  
  RESULTS
  Fifty-five women who underwent RVT gave birth to 58 children. Twenty-five (43 %) pregnancies were complicated by preterm rupture of membranes. Thirty infants (52 %) were born preterm, of with 17 (29 %) were < 32 gestational weeks (GW) and seven (12 %) were < 28 GW. There were significantly more premature rupture of membranes in pregnancies after RVT. Despite a higher occurrence of postnatal infections in newborns of mothers who underwent RVT, long-term outcomes are not affected negatively. Regarding overall morbidity, a trend to fewer postnatal complications, compared with the control group, was found.
  
  
  CONCLUSIONS
  Postnatal morbidity in infants of women who underwent RVT, based on trend, is decreased compared with controls. Intense medical observation and treatment during pregnancy, birth, and neonatal period may explain this finding. Neonates in the RVT group have a non-significantly elevated risk for postnatal infections. They do not show an additional risk due to the maternal operation. Their long-term postnatal outcome is not affected negatively.
authors.affiliation: Department of Gynecology, Charité-University Medicine Berlin, Berlin, Germany.
authors.forename: Mandy
authors.initials: M
authors.lastname: Mangler
authors.forename: Dorothee
authors.initials: D
authors.lastname: Speiser
authors.forename: Bich Doan
authors.initials: BD
authors.lastname: Nguyen
authors.forename: Malte
authors.initials: M
authors.lastname: Cremer
authors.forename: Christhardt
authors.initials: C
authors.lastname: Koehler
authors.forename: Achim
authors.initials: A
authors.lastname: Schneider
authors.forename: Malgorzata
authors.initials: M
authors.lastname: Lanowska
mesh_terms: D000328:Adult; D002543:Cerebral Hemorrhage / Q000453:epidemiology; D002657:Child Development; D004374:Ductus Arteriosus, Patent / Q000453:epidemiology; D005260:Female; D005858:Germany / Q000453:epidemiology; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature / Q000378:metabolism; D007235:Infant, Premature, Diseases / Q000453:epidemiology*; D008297:Male; D011247:Pregnancy; D011256:Pregnancy Outcome / Q000453:epidemiology*; D012123:Pulmonary Ventilation; D012119:Respiration; D018805:Sepsis / Q000453:epidemiology; D002583:Uterine Cervical Neoplasms / Q000601:surgery*; D014621:Vagina / Q000601:surgery*