Closure of the cervical os in patients after fertility preserving treatment for early cervical cancer - results of a prospective observational study.

Abstract:

INTRODUCTION:Up to 50% of the infants delivered after radical vaginal trachelectomy (RVT) are born prematurely. An effective strategy to reduce this number could be the closure of the cervical os (CCO). PATIENTS AND METHODS:Fifteen pregnant patients who had a RVT due to early cervical cancer were included in this prospective case control study. All patients were scheduled for CCO early in the second trimester. CCO was performed in 12 patients. Their data were compared to data from 125 pregnancies after a RVT without CCO. RESULTS:The patients who had CCO were compared to patients without CCO. One patient had an early rupture of the amniotic membranes prior to CCO. Two patients chose not to undergo CCO. In 12 patients CCO was performed without complications. There was no early preterm delivery in the CCO group as compared to a rate of 5% in 125 pregnancies in the non-CCO group. DISCUSSION:We developed a protocol to reduce the risk of preterm deliveries after a RVT. Digital examinations should be avoided. Vaginal checks for pH can discover ascending infections - the main cause of preterm deliveries after a RVT. Infections should be treated adequately. CCO can further reduce the risk of preterm deliveries after a RVT.

journal_name

J Perinat Med

authors

Mangler M,Lanowska M,Bartens A,Schindler A,Blohmer JU,Speiser D

doi

10.1515/jpm-2016-0231

subject

Has Abstract

pub_date

2017-11-27 00:00:00

pages

941-945

issue

8

eissn

0300-5577

issn

1619-3997

pii

/j/jpme.ahead-of-print/jpm-2016-0231/jpm-2016-0231

journal_volume

45

pub_type

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