title: Closure of the cervical os in patients after fertility preserving treatment for early cervical cancer - results of a prospective observational study.
abstract: BACKGROUND
  Up to 50% of the infants delivered after radical vaginal trachelectomy (RVT) are born prematurely. An effective strategy to reduce this number could be the closure of the cervical os (CCO).
  
  
  METHODS
  Fifteen pregnant patients who had a RVT due to early cervical cancer were included in this prospective case control study. All patients were scheduled for CCO early in the second trimester. CCO was performed in 12 patients. Their data were compared to data from 125 pregnancies after a RVT without CCO.
  
  
  RESULTS
  The patients who had CCO were compared to patients without CCO. One patient had an early rupture of the amniotic membranes prior to CCO. Two patients chose not to undergo CCO. In 12 patients CCO was performed without complications. There was no early preterm delivery in the CCO group as compared to a rate of 5% in 125 pregnancies in the non-CCO group.
  
  
  CONCLUSIONS
  We developed a protocol to reduce the risk of preterm deliveries after a RVT. Digital examinations should be avoided. Vaginal checks for pH can discover ascending infections - the main cause of preterm deliveries after a RVT. Infections should be treated adequately. CCO can further reduce the risk of preterm deliveries after a RVT.
authors.affiliation: .
authors.forename: Mandy
authors.initials: M
authors.lastname: Mangler
authors.affiliation: .
authors.forename: Malgorzata
authors.initials: M
authors.lastname: Lanowska
authors.affiliation: .
authors.forename: Anne
authors.initials: A
authors.lastname: Bartens
authors.affiliation: .
authors.forename: Aaron
authors.initials: A
authors.lastname: Schindler
authors.affiliation: .
authors.forename: Jens-Uwe
authors.initials: JU
authors.lastname: Blohmer
authors.affiliation: .
authors.forename: Dorothee
authors.initials: D
authors.lastname: Speiser
mesh_terms: D000328:Adult; D002277:Carcinoma / Q000601:surgery; D002584:Cervix Uteri / Q000601:surgery*; D005260:Female; D006801:Humans; D059351:Organ Sparing Treatments; D011183:Postoperative Complications / Q000517:prevention & control*; D011247:Pregnancy; D047928:Premature Birth / Q000517:prevention & control*; D011446:Prospective Studies; D000069339:Trachelectomy; D002583:Uterine Cervical Neoplasms / Q000601:surgery
keywords: Cervical cancer; fertility after radical trachelectomy; laser closure of the cervix; pregnancy in cancer patients; radical trachelectomy; reduction of preterm delivery after radical trachelectomy