Kasuga Yoshifumi, Hasegawa Keita, Hamuro Asuka, Fukuma Yuka, Tamai Junko, Tanaka Yuya, Ikenoue Satoru, Tanaka Mamoru
Department of Obstetrics and Gynecology, Keio University School of Medicine, Tokyo, Japan.
Int J Gynaecol Obstet. 2024 Jan;164(1):108-114. doi: 10.1002/ijgo.14935. Epub 2023 Jun 21.
The authors aimed to investigate the prevalence of pregnancy and obstetric outcomes in patients who underwent radical trachelectomy (RT) for early-stage cervical cancer in the Kanto area, Japan.
A survey among 113 perinatal centers affiliated with the Kanto Society of Obstetrics and Gynecology was conducted to investigate their experience in managing pregnancies following RT, between 2010 and 2020. The association between preterm delivery (before 34 gestational weeks) and a midtrimester short cervix (<13 mm) was evaluated.
The authors retrospectively collected maternal and perinatal data from 13 hospitals. There were 135 pregnancies among 115 women following RT. Of the 135 pregnancies, 32 were miscarriages (<12 gestational weeks: n = 22; >12 gestational weeks: n = 10), and 103 were delivered after 22 gestational weeks. The incidences of preterm delivery before 28 and 34 gestational weeks were 8.7% and 30.1%, respectively. A midtrimester short residual cervix was associated with preterm delivery (P = 0.046).
Since more than 100 pregnancies were recorded after RT in the Kanto area, many physicians had more opportunities to manage pregnancy after RT. Pregnancy following RT is associated with increased risk of preterm delivery, and midtrimester short residual cervix is a good predictor of preterm delivery.
作者旨在调查日本关东地区接受早期宫颈癌根治性宫颈切除术（RT）患者的妊娠率及产科结局。
对隶属于关东妇产科学会的113家围产期中心进行了一项调查，以了解它们在2010年至2020年期间管理RT术后妊娠的经验。评估早产（妊娠34周前）与孕中期宫颈短（<13毫米）之间的关联。
作者回顾性收集了13家医院的孕产妇和围产期数据。115名接受RT术的女性中有135次妊娠。在这135次妊娠中，32次流产（妊娠12周前：n = 22；>12周：n = 10），103次在妊娠22周后分娩。妊娠28周和34周前的早产发生率分别为8.7%和30.1%。孕中期宫颈残端短与早产相关（P = 0.046）。
由于关东地区记录了RT术后100多次妊娠，许多医生有更多机会管理RT术后的妊娠。RT术后妊娠与早产风险增加相关，孕中期宫颈残端短是早产的良好预测指标。
