Chapter 3 - Cervical cancer during pregnancy

Summary

This chapter describes the diagnosis, treatment, and prognosis for cervical cancer in pregnancy. The majority of women with early cervical cancer are asymptomatic and are diagnosed by abnormal cytology. Patients with advanced or disseminated disease can have a wide variety of symptoms including pelvic pain, flank pain, and respiratory distress. Conization during pregnancy should be viewed as diagnostic and not therapeutic due to a high rate of positive margins and residual disease as demonstrated by E. V. Hannigan. The clinical staging may include plain film radiographs, an intravenous pyelogram (IVP), or a barium enema, but not findings at the time of surgery, computerized tomography (CT), or magnetic resonance imaging (MRI). CT scanning can be performed with minimal risk in the pregnant patient and is helpful in determining the presence of lymphadenopathy or hydronephrosis. The effect of pregnancy on prognosis is controversial, especially in the higher stages of the disease.