Dept. of Obstetrics and Gynaecology, Faculty Hospital Kralovske Vinohrady, 3rd Medical Faculty, Charles University, Prague, Czech Republic.
National Medical Research Center for Obstetrics, Gynecology and Perinatology Ministry of Healthcare of Russian Federation, Moscow, Russia.
Best Pract Res Clin Obstet Gynaecol. 2021 Sep;75:101-112. doi: 10.1016/j.bpobgyn.2021.03.014. Epub 2021 Apr 22.
The article focuses on fertility-sparing management during pregnancy and obstetrical management after fertility-sparing surgery. Over the years, more women in developed countries tend to delay childbirth to a later age, which leads to cervical cancer more often diagnosed during pregnancy. The advances in our understanding of prognosis and treatment options in these patients have helped us to address avenues and to circumvent standard therapy and fetal demise, respecting maternal and fetal chances. Childbearing trends also lead to an increase in the number of patients considering fertility-sparing management when diagnosed with cervical cancer. Such management represents a challenge for obstetricians as prior cervical surgery is a known risk factor for various adverse events. These include decreased fertility, second trimester miscarriage, preterm labor, or preterm premature rupture of membranes. Watchful follow-up and various prophylactic measures are keys when striving for the best possible outcome.
本文重点介绍妊娠期间的保留生育力管理和保留生育力手术后的产科管理。近年来,越来越多的发达国家女性倾向于推迟生育年龄,这导致怀孕期间更常诊断出宫颈癌。我们对这些患者的预后和治疗选择的认识的提高,帮助我们找到了途径,避免了标准治疗和胎儿死亡,同时尊重了母婴的机会。生育趋势也导致越来越多的宫颈癌患者考虑保留生育力的管理。这种管理对产科医生来说是一个挑战,因为先前的宫颈手术是各种不良事件的已知危险因素。这些包括生育能力下降、孕中期流产、早产或胎膜早破。密切随访和各种预防措施是争取最佳结果的关键。