Prenatal care for woman after fertility-sparing surgery for cervical cancer

Czech version

Authors: P. Šimják ; A. Pařízek; J. Sláma
Authors‘ workplace: Gynekologicko‑porodnická klinika 1. LF UK a VFN, Praha, přednosta prof. MUDr. A. Martan, DrSc.
Published in: Ceska Gynekol 2020; 85(6): 422-429
Category: Review Article

Overview

Aim: To summarize the current knowledge about the care of pregnant women after fertility-preserving operations for cervical cancer.

Study type: Review article.

Setting: Department of Gynecology and Obstetrics, 1st Faculty of Medicine, Charles University and General University Hospital, Prague.

Methodology: Search of published literature on a given topic using the PubMed database.

Results: Pregnant women after fertility-sparing surgery for cervical cancer can benefit from screening and treatment for asymptomatic bacteriuria, cervical incompetence screening, and progressive cervical shortening by transvaginal ultrasonography. Tests to determine the presence of biomarkers of preterm birth in cervicovaginal fluid improve the prediction of preterm birth. Vaginal progesterone supplementation should be the primary prevention of preterm birth in all women after trachelectomy. Women with a history of preterm birth or late abortion may benefit from cerclage. The preferred mode of delivery is the cesarean section after 37 weeks of gestation.

Conclusion: Due to the lack of data, pregnancy management in women who have undergone fertility-sparing surgery for early cervical cancer is inconsistent. An increasing number of pregnancies after fertility-sparing surgery will likely prompt clinical research in this field.

Keywords:

fertility-sparing surgery – trachelectomy – Preterm birth – preterm premature rupture of membranes – cerclage – fetal fibronectin

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