Management Of Cervical Cancer In Pregnancy:Clinical Analysis Of9Cases

Objective:To analyze the clinical characteristics and the treatment of the cervical cancer during pregnancy.Methods:A cohort of10patients with cervical cancer diagnosed during pregnancy from February2000to February2014in ZheJiang University affiliated Women’ Hospital was retrospectively studied. One patient accepted cesarean then out of hospital without cure. Clinical information, gestational age at diagnosis, treatment options were analyzed.Results:The age of9patients is23to42years old, mean age is33.1years old. The mean gestational age at diagnosis is18weeks.5patients diagnosed during the first trimester,2patients at second trimester and2patients at third trimester respectively. The clinical manifestation of4patients is founding the cervix abnormal without manifestation, while3patients’ was vaginal bleeding and the orthers’ was contact bleeding. All patients were diagnosed by biopsy with pathological types of squamous cell carcinoma in8cases, half of which FIGO stages is Ibl, the orther4cases is Ib2, while1case is adenosquamous carcinoma Ib1. Cervical squamous cell carcinoma in pregnancy was very different with the non-pregnant patients in age, clinical stage, cell differentiation, tumor diameter and deep muscle infiltration. The tumor diameter of4cases in the squamous cell carcinoma was less than4cm, while the other were more than4cm.4first trimester patients gave up the fetal and received radical hysterectomy promptly after diagnosis.4second and third trimester patients all ended pregnancy by cesarean section,1patient then accepted chemotherapy, because the tumor reduced not obviously, just advised her went to accept radiotherapy.2cases accepted neoadjuvant chemotherapy after cesarean, then received radical hysterectomy.1case after the cesarean accepted the radical hysterectomy at the same time.1first trimester case did the radical hysterectomy first then did the chemotherapy. The neonates of the2patients at the third trimester were alive.1neonate of the patient at the second trimester was alive while the other was dead.Conclusion:Cervical squamous cell carcinoma in pregnancy was very different with the non-pregnant patients in age, clinical stage, cell differentiation, tumor diameter and deep muscle infiltration. Cervical squamous cell carcinoma in pregnancy were almost at the early stage, so the treatment should be designed individually. For the patients at the second or third trimester, they can accept the dalay treatment according to the gestational age, the clinical stage of the tumor as well as the desires of the patients.