Diagnosis and treatment of pregnancy complicated with cervical cancer
Objective To explore the clinical characteristics,pregnancy management,delivery time and treatment principles of pregnancy with cervical cancer.Methods The clinical data of 13 pregnant patients with cervical cancer admitted to Peking University People's Hospital from September 2014 to January 2023 were reviewed to analyze their gestational age,tumor pathological features,pregnancy termination time,treatment as well as maternal and fetal prognosis,providing reference for clinical diagnosis and therapy.Results ① A total of 13 pregnant women with cervical cancer were enrolled,with an average age of(32.15±4.79)years.There were 7 cases diagnosed in the second trimester(53.85％),5 cases in the third trimester(38.46％),and 1 case in the postpartum(7.69％).The average gestation week was 23+3 weeks,while the average age of termination of pregnancy was 35+1 weeks.There were 10 cases of early cervical cancer,accounting for 76.92％.② The clinical manifestations were irregular vaginal bleeding,while the main pathological types were adenocarcinoma and squamous carcinoma.③ All the 7 patients in the second trimester of pregnancy decided to undergo expectant treatment due to strong fertility intention,in which four of them received neoadjuvant chemotherapy.The average frequency of chemotherapy was 2.5 times,and paclitaxel+carboplatin was the first-line chemotherapy regimen.All received cesarean section within a limited period after fetal lung maturation,followed with hysterectomy and adjuvant therapy.In the third trimester of pregnancy,4 patients received caesarean section and follow-up treatment for cervical cancer immediately after diagnosis,and 1 patient requested to continue to expect treatment,then terminated pregnancy because of premature rupture of fetal membranes.Besides,1 patient refused to complete colposcopic biopsy during pregnancy,and was diagnosed to undergo radical hysterectomy after delivery.④ All patients had good maternal and fetal outcomes.Conclusions Pregnant women with cervical cancer tend to be elder.It is usually diagnosed in the second and third trimester of pregnancy.The co-testing of cytology and HPV during pregnancy should be enhanced.Most patients have a strong desire to retain the fetus,so that individual treatment should be carried out according to the patient's desire and clinical characteristics.Pelvic MRI and neoadjuvant chemotherapy during pregnancy are safe and feasible.
万方数据
维普
