Pregnancy outcomes following radical trachelectomy for early-stage cervical cancer: A retrospective observational study in the Kanto area, Japan

Int J Gynaecol Obstet. 2024 Jan;164(1):108-114. doi: 10.1002/ijgo.14935. Epub 2023 Jun 21.

Abstract

Objective: The authors aimed to investigate the prevalence of pregnancy and obstetric outcomes in patients who underwent radical trachelectomy (RT) for early-stage cervical cancer in the Kanto area, Japan.

Method: A survey among 113 perinatal centers affiliated with the Kanto Society of Obstetrics and Gynecology was conducted to investigate their experience in managing pregnancies following RT, between 2010 and 2020. The association between preterm delivery (before 34 gestational weeks) and a midtrimester short cervix (<13 mm) was evaluated.

Results: The authors retrospectively collected maternal and perinatal data from 13 hospitals. There were 135 pregnancies among 115 women following RT. Of the 135 pregnancies, 32 were miscarriages (<12 gestational weeks: n = 22; >12 gestational weeks: n = 10), and 103 were delivered after 22 gestational weeks. The incidences of preterm delivery before 28 and 34 gestational weeks were 8.7% and 30.1%, respectively. A midtrimester short residual cervix was associated with preterm delivery (P = 0.046).

Conclusion: Since more than 100 pregnancies were recorded after RT in the Kanto area, many physicians had more opportunities to manage pregnancy after RT. Pregnancy following RT is associated with increased risk of preterm delivery, and midtrimester short residual cervix is a good predictor of preterm delivery.

Keywords: cervical cancer; miscarriage; pregnancy; preterm delivery; trachelectomy; ultrasound.

Publication types

  • Observational Study

MeSH terms

  • Cervix Uteri / surgery
  • Female
  • Humans
  • Infant, Newborn
  • Japan / epidemiology
  • Pregnancy
  • Pregnancy Outcome
  • Premature Birth* / epidemiology
  • Premature Birth* / etiology
  • Retrospective Studies
  • Trachelectomy* / adverse effects
  • Uterine Cervical Neoplasms* / etiology
  • Uterine Cervical Neoplasms* / surgery

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