Skip to main content Accessibility help

We use cookies to distinguish you from other users and to provide you with a better experience on our websites. Close this message to accept cookies or find out how to manage your cookie settings.

Close cookie message
×
Hostname: page-component-848d4c4894-v5vhk Total loading time: 0 Render date: 2024-06-17T14:45:13.024Z Has data issue: false hasContentIssue false

Chapter 72 - Management of Malignant and Premalignant Disease of the Cervix during Pregnancy

from Section 9 - Co-Morbidities during Pregnancy

Published online by Cambridge University Press:  20 November 2021

By
Antonios Athanasiou ,
Panagiotis Cherouveim ,
Maria Kyrgiou  and
Evangelos Paraskevaidis
Edited by
Tahir Mahmood ,
Charles Savona Ventura ,
Ioannis Messinis  and
Sambit Mukhopadhyay
Tahir Mahmood
Affiliation:
Victoria Hospital, Kirkcaldy
Charles Savona Ventura
Affiliation:
University of Malta, Malta
Ioannis Messinis
Affiliation:
University of Thessaly, Greece
Sambit Mukhopadhyay
Affiliation:
Norfolk & Norwich University Hospital, UK
Get access

Summary

The rate of abnormal cytology smears during pregnancy is similar to that of non-pregnant women (around 5% in the USA). As expected, most of these abnormal smears are pre-cancerous cervical lesions, and cervical cancer during pregnancy is a rare event. However, it remains the most common cancer diagnosed during pregnancy, with an incidence rate of 12 per 100 000 pregnancies in the USA [1].

Type
Chapter
Information
The EBCOG Postgraduate Textbook of Obstetrics & Gynaecology
Obstetrics & Maternal-Fetal Medicine
 , pp. 587 - 594
Publisher: Cambridge University Press
Print publication year: 2021

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Yang, KY. Abnormal pap smear and cervical cancer in pregnancy. Clin Obstet Gynecol. 2012;55:838–48.CrossRefGoogle ScholarPubMed
Massad, LS, Einstein, MH, Huh, WK, et al. 2012 updated consensus guidelines for the management of abnormal cervical cancer screening tests and cancer precursors. J Low Genit Tract Dis. 2013;17:S1–27. doi: 10.1097/LGT.0b013e318287d329Google Scholar
Broderick, D, Matityahu, D, Dudhbhai, M, et al. Histologic and colposcopic correlates of ASCUS Pap smears in pregnancy. J Low Genit Tract Dis. 2002;6:116–19.CrossRefGoogle ScholarPubMed
Muller, CY, Smith, HO. Cervical neoplasia complicating pregnancy. Obstet Gynecol Clin North Am. 2005;32:533–46. doi: 10.1016/j.ogc.2005.08.007Google Scholar
Van Calsteren, K, Vergote, I, Amant, F. Cervical neoplasia during pregnancy: Diagnosis, management and prognosis. Best Pract Res Clin Obstet Gynaecol. 2005;19:611–30. doi: 10.1016/j.bpobgyn.2005.03.002CrossRefGoogle ScholarPubMed
Michael, CW, Esfahani, FM. Pregnancy-related changes: a retrospective review of 278 cervical smears. Diagn Cytopathol. 1997;17:99–107.3.0.CO;2-J>CrossRefGoogle ScholarPubMed
Public Health England. Programme and Colposcopy Management. Guidelines for commissioners, screening providers and programme managers for NHS cervical screening. 2016.Google Scholar
Economos, K, Perez Veridiano, N, Delke, I, et al. Abnormal cervical cytology in pregnancy: a 17-year experience. Obstet Gynecol. 1993;81:915–18.Google Scholar
Baldauf, JJ, Dreyfus, M, Ritter, J. Benefits and risks of directed biopsy in pregnancy. J Low Genit Tract Dis. 1997;1:214–20.Google Scholar
Kyrgiou, M, Koliopoulos, G, Martin-Hirsch, P, et al. Obstetric outcomes after conservative treatment for intraepithelial or early invasive cervical lesions: systematic review and meta-analysis. Lancet 2006;367:489–98. doi: 10.1016/S0140-6736(06)68181-6CrossRefGoogle ScholarPubMed
Dunn, TS, Ginsburg, V, Wolf, D. Loop-cone cerclage in pregnancy: a 5-year review. Gynecol Oncol. 2003;90:577–80. doi: 10.1016/S0090-8258(03)00395-0CrossRefGoogle ScholarPubMed
Paraskevaidis, E, Koliopoulos, G, Kalantaridou, S, et al. Management and evolution of cervical intraepithelial neoplasia during pregnancy and postpartum. Eur J Obstet Gynecol Reprod Biol. 2002;104:67–9.Google Scholar
Yost, NP, Santoso, JT, McIntire, DD, et al. Postpartum regression rates of antepartum cervical intraepithelial neoplasia II and III lesions. Obstet Gynecol. 1999;93:359–62.Google Scholar
Ahdoot, D, Van Nostrand, KM, Nguyen, NJ, et al. The effect of route of delivery on regression of abnormal cervical cytologic findings in the postpartum period. Am J Obstet Gynecol. 1998;178:1116–20.Google Scholar
American College of Obstetricians and Gynecologists. Committee Opinion No. 723: Guidelines for Diagnostic Imaging During Pregnancy and Lactation. Obstet Gynecol. 2017;130:e210–16. doi: 10.1097/AOG.0000000000002355Google Scholar
Elliott, P, Coppleson, M, Russell, P, et al. Early invasive (FIGO stage IA) carcinoma of the cervix: a clinico-pathologic study of 476 cases. Int J Gynecol Cancer. 2000;10:42–52.Google Scholar
Favero, G, Chiantera, V, Oleszczuk, A, et al. Invasive cervical cancer during pregnancy: laparoscopic nodal evaluation before oncologic treatment delay. Gynecol Oncol. 2010;118:123–7. doi: 10.1016/j.ygyno.2010.04.012CrossRefGoogle ScholarPubMed
Amant, F, Halaska, MJ, Fumagalli, M, et al. Gynecologic cancers in pregnancy: guidelines of a second international consensus meeting. Int J Gynecol Cancer. 2014;24:394–403. doi: 10.1097/IGC.0000000000000062Google Scholar
Berman, ML, Keys, H, Creasman, W, et al. Survival and patterns of recurrence in cervical cancer metastatic to periaortic lymph nodes (a Gynecologic Oncology Group study). Gynecol Oncol .1984;19:8–16.CrossRefGoogle ScholarPubMed
Prem, KA, Makowski, EL, McKelvey, JL. Carcinoma of the cervix associated with pregnancy. Am J Obstet Gynecol. 1966;95:99–108. doi: 10.1016/0002-9378(66)90634-XCrossRefGoogle ScholarPubMed
Parasnis, H, Raje, B, Hinduja, IN. Relevance of plasma fibrinogen estimation in obstetric complications. J Postgrad Med. 1992;38:183–5.Google ScholarPubMed
Itsukaichi, M, Kurata, H, Matsushita, M, et al. Stage Ia1 cervical squamous cell carcinoma: conservative management after laser conization with positive margins. Gynecol Oncol. 2003;90:387–9.Google Scholar
Schmeler, KM, Frumovitz, M, Ramirez, PT. Conservative management of early stage cervical cancer: is there a role for less radical surgery? Gynecol Oncol. 2011;120:321–5. doi: 10.1016/j.ygyno.2010.12.352Google Scholar
Salvo, G, Frumovitz, M, Pareja, R, et al. Simple trachelectomy with pelvic lymphadenectomy as a viable treatment option in pregnant patients with stage IB1 (≥2 cm) cervical cancer: bridging the gap to fetal viability. Gynecol Oncol. 2018;150:50–5. doi: 10.1016/j.ygyno.2018.05.021Google Scholar
Capilna, ME, Szabo, B, Becsi, J, et al. Radical trachelectomy performed during pregnancy: a review of the literature. Int J Gynecol Cancer. 2016;26:758–62. doi: 10.1097/IGC.0000000000000655Google Scholar
Takushi, M, Moromizato, H, Sakumoto, K, et al. Management of invasive carcinoma of the uterine cervix associated with pregnancy: outcome of intentional delay in treatment. Gynecol Oncol. 2002;87:185–9.CrossRefGoogle ScholarPubMed
Morice, P, Uzan, C, Gouy, S, et al. Gynaecological cancers in pregnancy. Lancet. 2012;379:558–69. doi: 10.1016/S0140-6736(11)60829-5Google Scholar
Peccatori, FA, Azim, HA, Orecchia, R, et al. Cancer, pregnancy and fertility: ESMO clinical practice guidelines for diagnosis, treatment and follow-up. Ann Oncol. 2013;24:vi160–70. doi: 10.1093/annonc/mdt199CrossRefGoogle ScholarPubMed
Amant, F, Van Calsteren, K, Halaska, MJ, et al. Long-term cognitive and cardiac outcomes after prenatal exposure to chemotherapy in children aged 18 months or older: an observational study. Lancet Oncol. 2012;13:256–64. doi: 10.1016/S1470-2045(11)70363-1CrossRefGoogle ScholarPubMed
Zagouri, F, Sergentanis, TN, Chrysikos, D, et al. Platinum derivatives during pregnancy in cervical cancer: a systematic review and meta-analysis. Obstet Gynecol. 2013;121:337–43. doi: 10.1097/AOG.0b013e31827c5822CrossRefGoogle ScholarPubMed
Sood, AK, Sorosky, JI, Mayr, N, et al. Cervical cancer diagnosed shortly after pregnancy: prognostic variables and delivery routes. Obstet Gynecol. 2000;95:832–8.Google Scholar
Van der Vange, N, Weverling, G, Ketting, B, et al. The prognosis of cervical cancer associated with pregnancy: a matched cohort study. Obstet Gynecol. 1995;85:1022–6. doi: 10.1016/0029-7844(95)00059-ZGoogle Scholar
Van den Broek, NR, Lopes, A, Ansink, A, et al. Microinvasive adenocarcinoma of the cervix implanting in an episiotomy scar. Gynecol Oncol. 1995;59:297–9. doi: 10.1006/gyno.1995.0025Google Scholar
Pavlidis, N, Pentheroudakis, G. Metastatic involvement of placenta and fetus in pregnant women with cancer. Recent Results Cancer Res Fortschritte Krebsforsch Progres Dans Rech Sur Cancer. 2008;178:183–94.Google Scholar

Save book to Kindle

To save this book to your Kindle, first ensure coreplatform@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about saving to your Kindle.

Note you can select to save to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

Find out more about the Kindle Personal Document Service.

Available formats
×

Save book to Dropbox

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Dropbox.

Available formats
×

Save book to Google Drive

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Google Drive.

Available formats
×