Management of pregnancy after radical trachelectomy

Kasuga, Yoshifumi; Ikenoue, Satoru; Tanaka, Mamoru; Ochiai, Daigo

doi:10.1016/j.ygyno.2021.04.023

Cited by 16 publications

(13 citation statements)

References 61 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Previous reports have described that expectant management could be useful and appropriate 19–21 . Since there is a fear of cervical laceration or intrauterine infection due to aspiration or D&C, expectant management was recommended in our previous review 11 . However, expectant management might be mentally difficult while waiting for natural discharge.…”

Section: Discussionmentioning

confidence: 95%

“…Reports suggest that preterm delivery due to preterm premature rupture of membrane (PROM) and abnormal bleeding from the varices at the site of uterovaginal anastomosis are important considerations in pregnancy following RT 7–10 . Although we reviewed pregnancy management after RT, it has not yet been shown to prevent preterm delivery, and many clinicians are trying to prevent adverse outcomes 11 . In Japan, RT as a treatment modality for women with early‐stage cervical cancer, is gaining popularity.…”

Section: Introductionmentioning

confidence: 99%

“…[7][8][9][10] Although we reviewed pregnancy management after RT, it has not yet been shown to prevent preterm delivery, and many clinicians are trying to prevent adverse outcomes. 11 In Japan, RT as a treatment modality for women with early-stage cervical cancer, is gaining popularity. However, the number of patients who are able to conceive and deliver children after RT remains unknown.…”

mentioning

confidence: 99%

See 2 more Smart Citations

Pregnancy outcomes following radical trachelectomy for early‐stage cervical cancer: A retrospective observational study in the Kanto area, Japan

Kasuga

Hasegawa

Hamuro

et al. 2023

Intl J Gynecology & Obste

Self Cite

View full text Add to dashboard Cite

ObjectiveThe 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.MethodA 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.ResultsThe 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).ConclusionSince 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.

show abstract

Section: Discussionmentioning

confidence: 95%

Section: Introductionmentioning

confidence: 99%

mentioning

confidence: 99%

See 1 more Smart Citation

Pregnancy outcomes following radical trachelectomy for early‐stage cervical cancer: A retrospective observational study in the Kanto area, Japan

Kasuga

Hasegawa

Hamuro

et al. 2023

Intl J Gynecology & Obste

Self Cite

View full text Add to dashboard Cite

show abstract

“…First, a small number of patients was included in this retrospective study. However, the number of patients with a history of AT is limited, and it is di cult to estimate a large number of patients for a prospective study; therefore, even a small study such as this one is important [23]. Second, this study was limited to ATs.…”

Section: Discussionmentioning

confidence: 99%

Decreased pregnancy rate per embryo transfer in women undergoing assisted reproductive technology after abdominal trachelectomy: A retrospective study

Fujita

Yoshioka

Ogawa

et al. 2022

Preprint

View full text Add to dashboard Cite

Purpose: To evaluate the assisted reproductive technology (ART) outcomes after abdominal trachelectomy (AT). Methods: This was a retrospective study. We compared the ART outcome of 13 patients who underwent AT at another hospital prior to undergoing ART at our clinic after surgery (T group) and 52 control patients selected based on age, the time of treatment onset, and anti-Müllerian hormone levels (non-T group). Results: In all oocyte retrieval cycles, there were no significant differences in the number of oocyte retrieval, rate of fertilization, and good blastocysts. The pregnancy and live birth rates per embryo transfer (ET) were lower in the T group than in the non-T group (pregnancy rate, 20% versus [vs.] 39%, p=0.0166; live birth rate, 15% vs. 30%, p=0.0281). Endometrial thickness before ET was lesser in the T group than in the non-T group (7.4 [minimum–maximum, 3.5–14.3] mm vs. 9.0 [5.5–14.9] mm, p<0.0001). Multivariate logistic regression models showed that the age at oocyte retrieval (adjusted odds ratio [OR], 0.78; 95% confidence interval [CI], 0.69–0.89), the presence of good embryos (adjusted OR, 3.17; 95% CI, 1.29–7.82), and a history of AT (adjusted OR, 0.35; 95% CI, 0.15–0.83) were factors related to pregnancy per ET. Conclusion: The pregnancy rate per ET was lower and the endometrium was thinner before ET in patients with than in those without a history of AT. It is important for clinicians to be aware of the longer time to pregnancy in patients on ART after AT.

show abstract

“…Despite obstetric guidelines for obstetric women with previous cancer do not exist yet, clinical conditions that could worsen during the gestation should be evaluated before seeking the pregnancy and monitored during the gestation. For example, women who received anthracyclines should undergo an echocardiogram before and during pregnancy to rule out possible heart issues related to previous chemotherapy [108] and women who received trachelectomy should be screened for cervical length as early as the first trimester and during pregnancy to evaluate a possible shortening [109].…”

Section: Pregnancies In Cancer Patientsmentioning

confidence: 99%

Fertility Preservation in Girls and Women: State of Art and Future Possibilities

Marin¹,

Ambrosini²,

Esposito³

et al. 2022

Clin. Exp. Obstet. Gynecol.

View full text Add to dashboard Cite

Background: Many women worldwide are diagnosed with cancer in prepubertal, postpubertal and childbearing age. Oncological treatments can compromise future fertility through different mechanisms mainly depending on the type of treatment and the age of the patient. International societies recommend that cancer patients should receive information regarding the effects of oncological treatments on their reproductive health and cancer survivors should not be discouraged from becoming pregnant. About a quarter of these patients still do not receive an adequate counselling and young cancer survivors may face several barriers to conceiving a pregnancy due to the concerns from gynaecologists and oncologists. Methods: This review aims to investigate the infertility risk for female cancer patients who undergo oncological treatments and to provide an overview of actual and future fertility preservation possibilities for female cancer patients. Results: Different fertility preservation techniques have been developed in order to ensure the possibility for cancer survivors to complete their family planning after cancer. Oocyte/embryo freezing and ovarian tissue cryopreservation are the established choices, but the research is still going on to increase the success rate of these techniques and to develop other techniques to overcome actual limitations. Patients with a systemic oncological disease such as leukaemia could particularly benefit from the new experimental techniques which involve the creation of an artificial ovary or the in vitro growth of follicles or even the obtaining of mature oocytes from stem cells. All these techniques would allow the achievement of pregnancy without the risk of reintroducing malignant cells within autologous cryopreserved ovarian tissue transplantation. Regarding the concerns over pregnancy in cancer survivors, research is rapidly advancing and reassuring data are increasing. Conclusions: The rate of utilisation of gametes, embryos or ovarian tissue previously stored for fertility preservation is still low and the motivations can be various. Further data are needed in order to reassure both women and oncologists about the safety of pregnancy in cancer survivors and in order to increase the rate of women experiencing pregnancy after cancer.

show abstract

Management of pregnancy after radical trachelectomy

Cited by 16 publications

References 61 publications

Pregnancy outcomes following radical trachelectomy for early‐stage cervical cancer: A retrospective observational study in the Kanto area, Japan

Pregnancy outcomes following radical trachelectomy for early‐stage cervical cancer: A retrospective observational study in the Kanto area, Japan

Decreased pregnancy rate per embryo transfer in women undergoing assisted reproductive technology after abdominal trachelectomy: A retrospective study

Fertility Preservation in Girls and Women: State of Art and Future Possibilities

Contact Info

Product

Resources

About