Obstetric complications as a challenge after radical trachelectomy: a review of the literature

• Published in: Journal of obstetrics and gynaecology Vol. 39; no. 7; pp. 885 - 888
• Main Authors: Sanchez-Migallon, Amalia, Lago, Victor, Matute, Luis, Domingo, Santiago
• Format: Journal Article
• Language: English
• Published: England Taylor & Francis 03-10-2019; Taylor & Francis Ltd
• Subjects: Carcinoma, Squamous Cell - surgery; Cervical cancer; Female; Fertility; fertility and assisted reproduction; Fetal Membranes, Premature Rupture; gynaecological oncology; Gynaecological surgery; Gynecological surgery; Humans; Obstetrics; Postoperative Complications; Pregnancy; Trachelectomy; Uterine Cervical Neoplasms - surgery; fertility and assisted reproduction; gynaecological oncology; Gynaecological surgery
• ISSN: 0144-3615; 1364-6893
• DOI: 10.1080/01443615.2019.1577812

Cervical cancer is the fourth most frequent cancer in women worldwide and the ninth cause of death in women between 30 and 49 years of age. Increase in early detection and diagnosis has allowed the implementation of more conservative management strategies. The radical trachelectomy (RT) is considered the treatment of choice for patients with early stage cervical cancer that desire fertility preservation, without compromising oncologic outcomes. The published data regarding reproductive and obstetric outcomes after RT reports decreased fertility, and increased abortion rates, prematurity and obstetric complications. On the other hand, data on oncologic outcomes has not shown higher rates of residual disease compared to radical hysterectomy. Data on obstetric outcomes following RT is scarce, generating controversy. We present the case of a patient diagnosed with stage IB1 cervical cancer managed with a vaginal radical trachelectomy (VRT), who subsequently had two successful gestations that resulted in premature deliveries with associated neonatal morbidity.