Abstract
Background
Pregnancy-related complications after vaginal radical trachelectomy (RT) for early-stage invasive uterine cervical cancer were studied in comparison with those occurring after laser conization. The strategy to reduce vaginal RT-related complications during pregnancy is also discussed.
Methods
Pregnancy courses after vaginal RT in two patients and those after laser conization in five patients, whose operations were performed during the same period, were studied with respect to symptoms, cervical length, and infectious signs.
Results
The cervix shortened progressively both in patients with laser conization and in those with RT. However, throughout the pregnancy, the remaining cervix after the operation was longer in patients who had undergone conization than in those who had undergone vaginal RT. After laser conization, two of the five patients suffered from preterm rupture of the membrane (PROM) at 36 weeks of gestation, and both patients who had undergone vaginal RT had premature PROM (pPROM), at 32 and 24 weeks of gestation, respectively.
Conclusion
Prevention of preterm labor and the following occurrence of pPROM is a significant task to be resolved in order to improve pregnancy outcome after vaginal RT for early-stage invasive uterine cervical cancer. Daily vaginal disinfection with povidone iodine and the administration of a ulinastatin vaginal suppository, bed rest, and the use of ritodrine would be the best approach, and a more conservative approach for stage Ia2 also might be taken into consideration.
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References
JH Shepherd C Spencer J Herod TEJ Ind (2006) ArticleTitleRadical vaginal trachelectomy as a fertility sparing procedure in women with early-stage cervical cancer: cumulative pregnancy rate in a series of 123 women BJOG 113 719–724 Occurrence Handle16709216 Occurrence Handle10.1111/j.1471-0528.2006.00936.x Occurrence Handle1:STN:280:DC%2BD28znvFejug%3D%3D
D Dargent X Martin A Sacchetoni et al. (2000) ArticleTitleLaparoscopic vaginal radical trachelectomy: a treatment to preserve the fertility of cervical carcinoma patients Cancer 88 1877–1882 Occurrence Handle10760765 Occurrence Handle10.1002/(SICI)1097-0142(20000415)88:8<1877::AID-CNCR17>3.0.CO;2-W Occurrence Handle1:STN:280:DC%2BD3c3isFKjsw%3D%3D
S Ishioka T Endo T Hayashi et al. (2006) ArticleTitleSuccessful delivery after vaginal radical trachelectomy for invasive uterine cervical cancer Int.J.Clin.Oncol 11 146–149 Occurrence Handle16622750 Occurrence Handle10.1007/s10147-005-0536-3
M Plante MC Renaud H Francois et al. (2004) ArticleTitleVaginal radical trachelectomy: an oncologically safe fertility-preserving surgery. An updated series of 72 cases and review of the literature Gynecol Oncol 94 614–623 Occurrence Handle15350349 Occurrence Handle10.1016/j.ygyno.2004.05.032
A Covens P Shaw J Murphy et al. (1999) ArticleTitleIs radical trachelectomy a safe alternative to radical hysterectomy for patients with stage IA-B carcinoma of the cervix? Cancer 86 2273–2279 Occurrence Handle10590368 Occurrence Handle10.1002/(SICI)1097-0142(19991201)86:11<2273::AID-CNCR15>3.0.CO;2-C Occurrence Handle1:STN:280:DC%2BD3c%2FlvFGrsw%3D%3D
B Hagen FE Skjeldestad (1993) ArticleTitleThe outcome of pregnancy after CO2 laser conisation of the cervix Br J Obstet Gynaecol 100 717–720 Occurrence Handle8399008 Occurrence Handle1:STN:280:ByuD3c7otlE%3D
HA Ricciotti L Burke M Kobelin et al. (1995) ArticleTitleUltrasound evaluation of cervical shortening after loop excision of the transformation zone (LETZ) Int J Gynaecol Obstet 50 175–178 Occurrence Handle7589754 Occurrence Handle10.1016/0020-7292(95)02432-C Occurrence Handle1:STN:280:BymD3svisl0%3D
DJ Gentry MS Baggish K Brady et al. (2000) ArticleTitleThe effects of loop excision of the transformation zone on cervical length: implications for pregnancy Am J Obstet Gynecol 182 516–520 Occurrence Handle10739501 Occurrence Handle10.1067/mob.2000.104209 Occurrence Handle1:STN:280:DC%2BD3c3gsVSjtg%3D%3D
L Raio F Ghezzi E Di Naro et al. (1997) ArticleTitleDuration of pregnancy after carbon dioxide laser conization of the cervix: influence of cone height Obstet Gynecol 90 978–982 Occurrence Handle9397115 Occurrence Handle10.1016/S0029-7844(97)00489-4 Occurrence Handle1:STN:280:DyaK1c%2FlvFaltg%3D%3D
S El-Shazly M Makhseed F Azizieh et al. (2004) ArticleTitleIncreased expression of pro-inflammatory cytokines in placentas of women undergoing spontaneous preterm delivery or premature rupture of membranes Am J Reprod Immunol 52 45–52 Occurrence Handle15214942 Occurrence Handle10.1111/j.1600-0897.2004.00181.x
M Sakai Y Sasaki S Yoneda et al. (2004) ArticleTitleElevated interleukin-8 in cervical mucus as an indicator for treatment to prevent premature birth and preterm, pre-labor rupture of membranes: a prospective study Am J Reprod Immunol 51 220–225 Occurrence Handle15209391 Occurrence Handle10.1111/j.1600-0897.2004.00145.x
P Petignat C Stan E Megevand et al. (2004) ArticleTitlePregnancy after trachelectomy: a high-risk condition of preterm delivery. Report of a case and review of the literature Gynecol Oncol 94 575–577 Occurrence Handle15297207 Occurrence Handle10.1016/j.ygyno.2004.05.039
MH Yudin (2005) ArticleTitleBacterial vaginosis in pregnancy: diagnosis, screening, and management Clin Perinatol 32 617–627 Occurrence Handle16085023 Occurrence Handle10.1016/j.clp.2005.05.007
A Shennan S Crawshaw A Briley (2006) ArticleTitleA randomised controlled trial of metronidazole for the prevention of preterm birth in women positive for cervicovaginal fetal fibronectin: the PREMET Study BJOG 113 65–70 Occurrence Handle16398774 Occurrence Handle10.1111/j.1471-0528.2005.00788.x Occurrence Handle1:CAS:528:DC%2BD28Xnt1yktw%3D%3D
JM Guise SM Mahon M Aickin et al. (2001) ArticleTitleScreening for bacterial vaginosis in pregnancy Am J Prev Med 20 IssueIDSuppl 62–72 Occurrence Handle11306234 Occurrence Handle10.1016/S0749-3797(01)00256-2 Occurrence Handle1:STN:280:DC%2BD38%2FgvVajtA%3D%3D
S Colman-Brochu (2004) ArticleTitleDeep vein thrombosis in pregnancy MCN Am J Matern Child Nurs 29 186–192 Occurrence Handle15123976 Occurrence Handle10.1097/00005721-200405000-00010
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Ishioka, Si., Endo, T., Hayashi, T. et al. Pregnancy-related complications after vaginal radical trachelectomy for early-stage invasive uterine cervical cancer. Int J Clin Oncol 12, 350–355 (2007). https://doi.org/10.1007/s10147-007-0688-4
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DOI: https://doi.org/10.1007/s10147-007-0688-4