INVASIVE CERVICAL CARCINOMA IN PREGNANT WOMEN: THE AUTHORS' OWN EXPERIENC

Cervical cancer is one of the most commonly diagnosed malignant tumors in pregnant women. The existing current standards of therapy for invasive cervical carcinoma during pregnancy include surgery and/or chemotherapy. The tactics for treating patients is determined by gestational age, stage of disease, and a woman’s desire to maintain her pregnancy. Objective. To generalize and analyze the authors’ own experience in managing pregnant women with invasive cervical carcinoma. Subjects and methods. Sixteen cases of invasive cervical carcinoma were retrospectively analyzed in pregnant women with a median age of 34.5 years; the period of initial diagnosis was 21.6 weeks. Results. Pregnancy was complicated by threatened miscarriage in the first trimester in 18.75% of cases; atypical conization was performed in 25%; 2 (12.5%) patients received neoadjuvant chemotherapy. Delivery at term occurred in 62.5% of patients, preterm delivery in 31.2%. The median gestational age at delivery was 36.3 weeks. Cesarean section was performed in 68.7%. Wertheim’s operation following cesarean section was made in 7 (43.7%) patients and with ovarian transposition in 57%. The weight of newborn babies was 3025±312 g. Within 1 year after their birth, the infants developed according to age norms. Conclusion. Due to the introduction of clinical protocols into practice, since 2019 material should be collected from the cervix uteri for cytological examination from all pregnant women when registered at a women’s health center. Compliance with the rules for the collection and transportation of cytological material, as well as its careful interpretation, is the key to the timely identification of patients at risk for cervical cancer. Additional examination of these patients, by carrying out tests for human papillomavirus and colposcopy, and, if necessary, targeted colposcopic biopsy will be able to reduce the frequency of late diagnosis of cervical cancer.

invasive cervical carcinoma, pregnancy, chemotherapy, staging, cesarean section, Wertheim’s operation