Obstetric complications as a challenge after radical trachelectomy: a review of the literature

Abstract

Cervical cancer is the fourth most frequent cancer in women worldwide and the ninth cause of death in women between 30 and 49 years of age. Increase in early detection and diagnosis has allowed the implementation of more conservative management strategies. The radical trachelectomy (RT) is considered the treatment of choice for patients with early stage cervical cancer that desire fertility preservation, without compromising oncologic outcomes. The published data regarding reproductive and obstetric outcomes after RT reports decreased fertility, and increased abortion rates, prematurity and obstetric complications. On the other hand, data on oncologic outcomes has not shown higher rates of residual disease compared to radical hysterectomy. Data on obstetric outcomes following RT is scarce, generating controversy. We present the case of a patient diagnosed with stage IB1 cervical cancer managed with a vaginal radical trachelectomy (VRT), who subsequently had two successful gestations that resulted in premature deliveries with associated neonatal morbidity.

Keywords: Gynaecological surgery; fertility and assisted reproduction; gynaecological oncology.