Diagnosis and treatment of cervical cancer during pregnancy

Authors

  • Carla Vitola Gonçalves Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo
  • Geraldo Duarte Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo
  • Juvenal Soares Dias da Costa Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo
  • Alessandra Cristina Marcolin Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo
  • Mônia Steigleder Bianchi Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo
  • Daison Dias Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo
  • Luis Cláudio de Velleca e Lima Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo

Keywords:

Uterine cervical neoplasms, Uterine cervical dysplasia, Diagnosis, Treatment effectiveness, Treatment protocols, Pregnancy

Abstract

CONTEXT AND OBJECTIVE: One third of all cervical carcinomas occur during the reproductive period. Cervical carcinoma is the second greatest cause of death due to cancer during this phase. The estimated frequency of cervical cancer during pregnancy is one case for every 1,000 to 5,000 pregnancies. The aim here was to provide information about the difficulties in diagnosing and managing cervical neoplasia during pregnancy. MATERIALS: A systematic review of the literature was undertaken through the PubMed, Cochrane, Excerpta Medica (Embase), Literatura Latino Americana e do Caribe em Ciências da Saúde (Lilacs) and Scientific Electronic Library Online (SciELO) databases, using the following words: pregnancy, cervical cancer, diagnosis and management. RESULTS: There was a consensus in the literature regarding diagnosis of cervical carcinoma and management of preneoplastic lesions during pregnancy. However, for management of invasive carcinoma, there was great divergence regarding the gestational age taken as the limit for observation rather than immediate treatment. CONCLUSION: All patients with cytological abnormalities should undergo colposcopy, which will indicate and guide biopsy. Conization is reserved for patients with suspected invasion. High-grade lesions should be monitored during pregnancy and reevaluated after delivery. In cases of invasive carcinoma detected up to the 12th week of pregnancy, patient treatment is prioritized. Regarding diagnoses made during the second trimester, fetal pulmonary maturity can be awaited, and the use of chemotherapy to stabilize the disease until the time of delivery appears to be viable.

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Author Biographies

Carla Vitola Gonçalves, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo

MD. Adjunct professor, Mother-Child Department, Universidade Federal do Rio Grande (FURG), Rio Grande, Rio Grande do Sul, Brazil.

Geraldo Duarte, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo

MD, PhD. Titular professor, Department of Gynecology and Obstetrics, Faculdade de Medicina de Ribeirão Preto (FMRP), Universidade de São Paulo (USP), Ribeirão Preto, São Paulo, Brazil.

Juvenal Soares Dias da Costa, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo

MD. Adjunct professor, Department of Social Medicine, Universidade Federal de Pelotas (UFPel), Pelotas, Rio Grande do Sul, Brazil.

Alessandra Cristina Marcolin, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo

MD. Gynecologist and Obstetrician, Hospital das Clínicas (HC), Faculdade de Medicina de Ribeirão Preto (FMRP), Universidade de São Paulo (USP), Ribeirão Preto, São Paulo, Brazil.

Mônia Steigleder Bianchi, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo

Undergraduate medical student, Universidade Federal do Rio Grande (FURG), Rio Grande, Rio Grande do Sul, Brazil.

Daison Dias, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo

Undergraduate medical student, Universidade Federal de Pelotas (UFPel), Pelotas, Rio Grande do Sul, Brazil.

Luis Cláudio de Velleca e Lima, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo

Undergraduate medical student, Universidade Federal de Pelotas (UFPel), Pelotas, Rio Grande do Sul, Brazil.

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Published

2009-11-11

How to Cite

1.
Gonçalves CV, Duarte G, Costa JSD da, Marcolin AC, Bianchi MS, Dias D, Lima LC de V e. Diagnosis and treatment of cervical cancer during pregnancy. Sao Paulo Med J [Internet]. 2009 Nov. 11 [cited 2025 Oct. 15];127(6):359-65. Available from: https://periodicosapm.emnuvens.com.br/spmj/article/view/1915

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Vol. 127 No. 6 (2009)

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