Clinical analysis of 21 cases of cervical cancer during pregnancy
Objective To analyze the clinical characteristics and prognosis of cervical cancer during pregnancy,and explore the screening,management,and treatment of pregnancy.Method The clinical data of 21 patients with cervical cancer during pregnancy who were admitted to Beijing Obstetrics and Gynecology Hospital Affiliated to Capital Medical University and International Peace Maternal and Child Health Hospital Affiliated to Shanghai Jiao Tong University School of Medicine from January 2015 to January 2023 were retrospectively analyzed.The clinical manifestations,histopathological examination results,treatment methods and pregnancy outcomes were summarized.Result A total of 21 patients with cervical cancer during pregnancy.7 patients had recurrent vaginal bleeding during pregnancy,and cervical mass was found after treatment,or cauliflower-shaped,or hard mass,with rough surface.The pathological examination of colposcopy suggested cervical cancer,and the other 14 patients had no specific clinical manifestations.Among them,7 cases were miscarriage,9 cases were premature delivery,and 5 cases were full-term delivery.The histopathological examination results suggested cervical adenocarcinoma in 2 cases,cervical adenosquamous carcinoma in 4 cases,endometrioid adenocarcinoma in 1 case,and cervical squamous carcinoma in 14 cases.Among the 8 patients with cervical cancer stage Ⅰa1,1 case was treated postpartum,1 case was treated postpartum after 16 weeks of pregnancy,5 cases were treated after abortion,and 1 case was treated after cesarean section.Postpartum surgical treatment for 1 case with stage Ⅰa2 cervical cancer.1 case of cervical cancer stage Ⅰb1 patient underwent surgical treatment at 9 weeks of pregnancy.1 case of cervical cancer stage Ⅰb2 patient underwent surgical treatment at 8 weeks of pregnancy.1 case of cervical cancer stage Ⅰb3 patient underwent surgical treatment after cesarean section at 34 weeks of pregnancy.Postpartum surgery combined with radiotherapy and chemotherapy for 1 case with stage Ⅱa1 cervical cancer.Among the 3 cases of cervical cancer stage Ⅱa2,1 case was treated with TC regimen(paclitaxel + carboplatin)for 5 times during pregnancy,and was treated with surgical treatment combined with postoperative radiotherapy after cesarean section;1 case was delayed to cesarean section at the expected gestational age,and was treated with surgical treatment combined with postoperative radiotherapy after cesarean section;1 case was given TC chemotherapy twice at 20 weeks of gestation and underwent surgery after cesarean section.5 cases with cervical cancer stage Ⅱb were given radiotherapy and/or chemotherapy and/or surgery after cesarean section.Follow-up to January 2023,except for 3 cases of miscarriage and 2 cases of lost to follow-up,the mother and baby are currently in good condition.Conclusion Early screening,diagnosis,and diversified treatment options for cervical cancer during pregnancy can prolong gestational weeks,reduce maternal and infant complications,and improve the quality of maternal and infant survival.
Cervical cancerPregnancyDiagnosis and treatmentPregnancy outcome
万方数据
维普
