Obstetric Outcomes and Complications After Vaginal Radical Trachelectomy: A Case Report

Abstract

We report a healthy 35-year-old Caucasian primigravida with a history of vaginal trachelectomy, cervical cerclage and laparoscopic pelvic lymphadenectomy for stage 1b1 cervical cancer. She had had a spontaneous conception and received appropriate antenatal care. She presented at 23+5 weeks gestation for leaking of liquor. Speculum examination confirmed preterm premature ruptured of membrane (PPROM) with her ultrasound showing oligohydramnios. She was admitted and despite intravenous (IV) antibiotics, developed chorioamnionitis. Emergency cesarean section was immediately performed due to maternal sepsis from chorioamnionitis. There was significant hemorrhage requiring the use of carbetocin for uterine contraction. A baby girl weighing 890 g was delivered via breech extraction with an Apgar score of 4 at 1 minute and 6 at 5 minutes of birth. The baby was admitted into NICU after intubation due to poor respiratory effort and developed complications of extreme prematurity, such as respiratory disorders, cardiovascular malformations, neurological and ophthalmological complications. Maternal post-operative recovery had also been complicated by wound infection that required extended antibiotics and regular wound care.