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Obstetric management following fertility-sparing radical vaginal trachelectomy for cervical cancer
  1. LJ Knight1,
  2. N Acheson1,
  3. TA Kay1,
  4. JN Renninson1,
  5. JH Shepherd2,
  6. MJO Taylor1
  1. 1The Royal Devon & Exeter Hospital, Exeter, UK
  2. 2The Royal Marsden Hospital, London, UK

Abstract

Radical vaginal trachelectomy now affords a fertility-sparing procedure for the treatment of early-stage cervical cancer in young women. Subsequent obstetric management within this group of women remain a challenge to the obstetrician, with risks of premature labour a continuing probability throughout pregnancy. Here the authors describe four cases of successful pregnancy following radical vaginal trachelectomy within our unit. The merits of early antenatal intervention, regular lower uterine segment length monitoring and use of daily progesterone pessaries are discussed alongside the current supportive evidence. The authors conclude with a discussion of proposed recommendations for obstetric management of pregnancy in women postradical vaginal trachelectomy.

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