Diagnosis and treatment of cervical cancer during pregnancy

Sao Paulo Medical Journal

Carla Vitola Gonçalves²  Geraldo Duarte¹  Juvenal Soares Dias Da Costa¹  Alessandra Cristina Marcolin¹  Mônia Steigleder Bianchi¹  Daison Dias¹  Luis Cláudio De Velleca E Lima¹ 

[1] ,Universidade Federal do Rio Grande Mother-Child Department Rio Grande Rio Grande do Sul ,Brazil

关键词: Uterine cervical neoplasms;    Uterine cervical dysplasia;    Diagnosis;    Treatment effectiveness;    Treatment protocols;    Pregnancy;    Neoplasia do colo do útero;    Displasia do colo do útero;    Diagnóstico;    Resultado de tratamento;    Protocolos clínicos;    Gravidez;   

DOI  :  10.1590/S1516-31802009000600008

来源: SciELO

【 摘 要 】

CONTEXT AND OBJECTIVE: One third of all cervical carcinomas occur during the reproductive period. Cervical carcinoma is the second greatest cause of death due to cancer during this phase. The estimated frequency of cervical cancer during pregnancy is one case for every 1,000 to 5,000 pregnancies. The aim here was to provide information about the difficulties in diagnosing and managing cervical neoplasia during pregnancy. MATERIALS: A systematic review of the literature was undertaken through the PubMed, Cochrane, Excerpta Medica (Embase), Literatura Latino Americana e do Caribe em Ciências da Saúde (Lilacs) and Scientific Electronic Library Online (SciELO) databases, using the following words: pregnancy, cervical cancer, diagnosis and management. RESULTS: There was a consensus in the literature regarding diagnosis of cervical carcinoma and management of preneoplastic lesions during pregnancy. However, for management of invasive carcinoma, there was great divergence regarding the gestational age taken as the limit for observation rather than immediate treatment. CONCLUSION: All patients with cytological abnormalities should undergo colposcopy, which will indicate and guide biopsy. Conization is reserved for patients with suspected invasion. High-grade lesions should be monitored during pregnancy and reevaluated after delivery. In cases of invasive carcinoma detected up to the 12th week of pregnancy, patient treatment is prioritized. Regarding diagnoses made during the second trimester, fetal pulmonary maturity can be awaited, and the use of chemotherapy to stabilize the disease until the time of delivery appears to be viable.

【 授权许可】

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