Cervical cancer in pregnancy in Songklanagarind Hospital
Abstract
Cervical cancer in pregnancy is increasingly reported worldwide nowadays. We studied eleven Thai pregnant women presenting with the clinical symptoms and signs of cervical cancer at Songklanagarind Hospital in Hat-Yai, Thailand between 1982-2001. Their mean age was 35.5 (range 30 to 41) years. The most common presenting symptom was vaginal bleeding, occurring in six patients (54.5%). Four patients (36.4%) were asymptomatic. The diagnosis of cervical cancer was made by biopsy of a gross lesion in seven of the women (63.6%). Four patients were referred for an abnormal Papanicolaou smear, and invasive disease was confirmed by colposcopic directed biopsy. A cone biopsy was performed without complications to the pregnancy in one patient diagnosed with microinvasion. Five patients (45.5%) were diagnosed before 20 weeks gestation. Most patients had stage I lesions. The predominant histologic cell type was squamous cell carcinoma in 8 cases (72.7%), followed by adenocarcinoma in 3 cases (27.3%). Eight patients postponed therapy to optimize fetal outcome, with a mean diagnosis-to-treatment interval of 134 days (range 27-327). Seven patients are free of disease after follow-up for 28 to 82 months. Patients in this study mostly had a good outcome.
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