Document Detail


Cervical neoplasia during pregnancy: diagnosis, management and prognosis.
MedLine Citation:
PMID:  15886059     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Pregnancy represents an exceptional opportunity for the early diagnosis of cervical cancer since visual inspection, cytological examination and bimanual palpation are considered to be part of routine antenatal care. An abnormal cervical smear should generally be managed as in the non-pregnant state. However, colposcopy and biopsies are mainly intended to exclude invasive disease because a conservative approach is preferred in cases of pre-invasive disease. The only absolute indication for conization in pregnancy is to rule out (micro-)invasive disease or make the diagnosis of invasive carcinoma when such a diagnosis will alter the timing or mode of delivery. Overall, earlier stages of cervical cancer are encountered during pregnancy compared with the general population. Although stage of disease and gestational age will largely influence the timing of the interventions, treatment of invasive cervical cancer is similar to the non-pregnant state. In strongly desired pregnancies, the use of neo-adjuvant chemotherapy in order to obtain fetal maturity should be considered and discussed with the patient. Although good evidence supports short-term safety, long-term data regarding the in-utero exposure of cytotoxic drugs need to be consolidated. After stratifying for stage, the outcome is similar to the non-pregnant state.
Authors:
K Van Calsteren; I Vergote; F Amant
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Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  Best practice & research. Clinical obstetrics & gynaecology     Volume:  19     ISSN:  1521-6934     ISO Abbreviation:  Best Pract Res Clin Obstet Gynaecol     Publication Date:  2005 Aug 
Date Detail:
Created Date:  2005-09-09     Completed Date:  2006-03-09     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101121582     Medline TA:  Best Pract Res Clin Obstet Gynaecol     Country:  England    
Other Details:
Languages:  eng     Pagination:  611-30     Citation Subset:  IM    
Affiliation:
Division of Gynaecological Oncology, Department of Obstetrics and Gynaecology, University Hospitals Leuven, Katholieke Universiteit Leuren, Herestraat 49, 3000 Leuven, Belgium.
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MeSH Terms
Descriptor/Qualifier:
Biopsy / methods
Cervical Intraepithelial Neoplasia / pathology,  therapy
Cervix Uteri / pathology
Colposcopy / methods
Combined Modality Therapy / methods
Delivery, Obstetric / methods
Female
Fetus
Gestational Age
Humans
Neoplasm Invasiveness
Pregnancy
Pregnancy Complications, Neoplastic / diagnosis*,  pathology,  therapy
Prognosis
Uterine Cervical Neoplasms / diagnosis*,  pathology,  therapy

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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