Clinical analysis of pregnancies after vaginal radical trachelectomy

Liangkun MA; Dongyan Cao; Jiaxin Yang; Qingwei QI; Jinsong Gao; Juntao Liu; Jianqiu Yang; Yang Xiang; Keng Shen; Jinghe Lang

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Clinical analysis of pregnancies after vaginal radical trachelectomy

VernacularTitle:广泛性子宫颈切除术后妊娠临床分析
Author: Liangkun MA ; Dongyan CAO ; Jiaxin YANG ; Qingwei QI ; Jinsong GAO ; Juntao LIU ; Jianqiu YANG ; Yang XIANG ; Keng SHEN ; Jinghe LANG
Publication Type:Journal Article
Keywords: Uterine cervical neoplasms; Gynecologic surgical procedures; Pregnancy rate; Pregnancy outcome; Cesarean section
From: Chinese Journal of Obstetrics and Gynecology 2012;(12):883-887
CountryChina
Language:Chinese
Abstract: Objective To explore the pregnancy outcome and obstetric management of pregnancy and delivery after vaginal radical trachelectomy (VRT).Methods Forty-two cases of VRT from December 2003 to May 2012 in Peking Union Medical College Hospital were analyzed retrospectively.Among them ten cases got pregnant successfully.Results The average age of patient at VRT surgery was (30.6 ± 3.7) years old and average follow-up time was 29.5 months.There were 31 patients attempted conception.Ten of them got fourteen conceptions successfully.Overall conception rate was 45％ (14/31).There were four cases of first trimester abortion.Among them,two were miscarriage,two were elective abortion.There was one case of ectopic pregnancy operation and non of second trimester loss.Nine cases reached the third trimester.The total preterm delivery rate was 4/9.There were two cases delivered before 32 gestational weeks (2/9).Cesarean section was performed through a transverse incision in all of nine cases.No uterine rupture and postpartum hemorrhage occurred.All newborns had good outcomes.The average follow-up time after postpartum was 22.9 months.All cases were disease-free.Conclusions The conception rate of patients after VRT in our series is 45％.The preterm birth rate of pregnancy after VRT is higher.Routine cerclage of cervix during VRT procedure and pregnancy is not necessary.Cesarean section shortly after full term pregnancy through a transverse incision should be considered as a suitable and safe procedure.