title: Reproductive and obstetric outcomes after radical abdominal trachelectomy for early-stage cervical cancer in a series of 31 pregnancies.
abstract: OBJECTIVE
  What are the reproductive and obstetric outcomes in patients undergoing radical abdominal trachelectomy (RAT) for early-stage cervical cancer?
  
  
  CONCLUSIONS
  When RAT was performed before a pregnancy achieved with fertility treatments, pregnancy rate of 36.2% was obtained and 71.4% of these women gave birth at ≥ 32 weeks of gestation.
  
  
  BACKGROUND
  Reproductive and obstetric outcomes after radical vaginal trachelectomy (RVT) are well documented; however, these outcomes after RAT have not been well studied.
  
  
  METHODS
  This is a retrospective cohort study of patients at a single institution who underwent RAT and became pregnant. Reproductive and obstetric outcomes of 114 patients who had undergone RAT from September 2002 to December 2010 were investigated.
  
  
  METHODS
  Women of reproductive age with early-stage cervical cancer who wished to preserve their fertility were documented.
  
  
  RESULTS
  Patients' median age was 33 years (25-40 years). A total of 31 pregnancies were achieved in 25 patients and 6 patients had 2 pregnancies. Eighteen of 25 patients (72.0%) had infertility problems; 17 patients conceived with IVF-embryo transfer and 1 patient with intrauterine insemination. The pregnancy rate among patients who wished to conceive was 36.2% (25/69). Among 31 pregnancies in 25 patients, 4 patients had first trimester miscarriage and 1 patient had second trimester miscarriage. Excluding the five patients who miscarried and the five ongoing pregnancies, all the 21 patients had deliveries by Cesarean section. Four patients had a preterm birth in the second trimester and 17 patients delivered in the third trimester. Of the 17 pregnancies that reached the third trimester, 2 (11.8%) were preterm births between 29 and 32 weeks, 11 (64.7%) were delivered between 32 and 37 weeks and 4 (23.5%) at ≥ 37 weeks of gestation.
  
  
  CONCLUSIONS
  Because of the retrospective data collection, not all pregnancies may have been recorded.
  
  
  CONCLUSIONS
  Prospective multicenter studies are needed to determine if the results shown in this retrospective cohort can be generalized to all patients with early-stage cervical cancer who wish to undergo the fertility-sparing RAT procedure.
authors.affiliation: Department of Obstetrics and Gynecology, School of Medicine, Keio University, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan.
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Nishio
authors.forename: Takuma
authors.initials: T
authors.lastname: Fujii
authors.forename: Juri
authors.initials: J
authors.lastname: Sugiyama
authors.forename: Naoaki
authors.initials: N
authors.lastname: Kuji
authors.forename: Mamoru
authors.initials: M
authors.lastname: Tanaka
authors.forename: Toshio
authors.initials: T
authors.lastname: Hamatani
authors.forename: Kei
authors.initials: K
authors.lastname: Miyakoshi
authors.forename: Kazuhiro
authors.initials: K
authors.lastname: Minegishi
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Tsuda
authors.forename: Takashi
authors.initials: T
authors.lastname: Iwata
authors.forename: Kyoko
authors.initials: K
authors.lastname: Tanaka
authors.forename: Takeshi
authors.initials: T
authors.lastname: Fukuchi
authors.forename: Yuji
authors.initials: Y
authors.lastname: Takehara
authors.forename: Yasunori
authors.initials: Y
authors.lastname: Yoshimura
authors.forename: Daisuke
authors.initials: D
authors.lastname: Aoki
mesh_terms: D000328:Adult; D002584:Cervix Uteri / Q000601:surgery*; D005260:Female; D013509:Gynecologic Surgical Procedures / Q000009:adverse effects; D006801:Humans; D011183:Postoperative Complications; D011247:Pregnancy; D011248:Pregnancy Complications / Q000453:epidemiology; D011256:Pregnancy Outcome; D012189:Retrospective Studies; D016896:Treatment Outcome; D002583:Uterine Cervical Neoplasms / Q000601:surgery*
keywords: cervical cancer; fertility sparing; obstetric outcome; pregnancy; radical abdominal trachelectomy