Obstet Gynecol Sci.  2013 Sep;56(5):289-300.

Gynecologic malignancy in pregnancy

• Ji YI
• Kim KT

Abstract

Gynecologic malignancy during pregnancy is a stressful problem. For the diagnosis and treatment of malignancy during pregnancy, a multidisciplinary approach is needed. Patients should be advised about the benefits and risk of treatment. When selecting a treatment for malignancy during pregnancy, the physiologic changes that occur with the pregnancy should be considered. Various diagnostic procedures that do not harm the fetus can be used. Laparoscopic surgery or laparotomy may be safely performed. The staging approach and treatment should be standard. Systemic chemotherapy during the first trimester should be delayed if possible. Radiation therapy should preferably start postpartum. Although delivery should be delayed preferably until after 35 weeks of gestation, termination of pregnancy may be considered when immediate treatment is required. Subsequent pregnancies do not increase the risk of malignancy recurrence.

Keyword

Chemotherapy; Gynecologic cancer; Pregnancy; Radiotherapy

MeSH Terms

Female
Fetus
Humans
Laparoscopy
Laparotomy
Postpartum Period
Pregnancy
Pregnancy Trimester, First
Recurrence

Figure

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  Fig. 1 Guidelines of an International Consensus: algorithm of cervical cancer. (A) Cervical cancer stage IB, <2 cm treated during second trimester wishing to preserve the fertility and pregnancy. (B) Cervical cancer stage IB1, 2 to 4 cm treated during second trimester wishing to preserve the fertility and pregnancy: lymphadenectomy. (C) Cervical cancer stage IB1, 2 to 4 cm treated during second trimester wishing to preserve the fertility and pregnancy: neoadjuvant chemotherapy followed by lymphadenectomy. (D) Cervical cancer stage IB2-IIB treated during second trimester wishing to preserve the fertility and pregnancy.

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