Cervical Carcinoma in Early Pregnancy – Successful Birth by Caesarean Section Followed by Radical Hysterectomy

Abstract

A cervical carcinoma was diagnosed in a 32-year-old patient in the 17th week of her pregnancy. The histological confirmation revealed a well-differentiated squamous cell carcinoma. It was a clinical stage Ib1 tumour, without enlarged lymph nodes according to the image. After a staging MRI, intensive education of the patient and case discussion at the interdisciplinary tumour board as well as consultation with the neonatologist, it was agreed to prolong the pregnancy under close monitoring. The carcinoma was confined to the cervix in the further course of the pregnancy. The elective delivery was planned after 32 weeks of gestation. The primary Caesarean section followed by radical hysterectomy Piver II were carried out without complications. After regular postoperative progression of the mother, brachytherapy was performed at the appropriate time. The premature newborn was under neonatal care and exhibited good postnatal adaptation. Mother and child were discharged in good health.

Zusammenfassung

Bei einer 32-jährigen Patientin wurde in der 17. Schwangerschaftswoche ein Zervixkarzinom diagnostiziert. Die histologische Sicherung ergab ein gut differenziertes Plattenepithelkarzinom. Es handelt sich um ein klinisches Tumorstadium Ib1, bildgebend ohne vergrößerte Lymphknoten. Nach Staging-MRT, intensiver Aufklärung der Patientin und Falldiskussion im interdisziplinären Tumorboard sowie Absprache mit den Neonatologen wurde die Prolongation der Schwangerschaft unter engmaschiger Kontrolle vereinbart. Das Karzinom blieb im weiteren Schwangerschaftsverlauf auf die Zervix beschränkt. Die elektive Entbindung wurde nach 32 SSW geplant. Die primäre Sectio caesarea mit anschließender radikaler Hysterektomie nach Piver II verlief ohne Komplikationen. Bei regelrechtem postoperativem Verlauf der Mutter wurde zeitgerecht die Brachytherapie durchgeführt. Das prämature Neugeborene wurde bei guter postnataler Adaptation neonatologisch betreut. Mutter und Kind konnten gesund nach Hause entlassen werden.

Key words

cervical carcinoma - pregnancy - radical hysterectomy - Caesarean section

Schlüsselwörter

Zervixkarzinom - Schwangerschaft - radikale Hysterektomie - Kaiserschnitt

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