Conservative Treatment of Uterine Cervical Adenocarcinoma in Pregnancy

Cancer of the cervix is the most common malignancy diagnosed during pregnancy, with an incidence of 1–10 cases per 10,000 pregnancies. The desire of patients to maintain pregnancy and subsequent fertility is a difficult target to be achieved and should be widely studied, since it depends on the stage of disease, gestational age at diagnosis, and the woman's desire to maintain pregnancy. We describe in this report the case of a pregnant woman with invasive cervical adenocarcinoma in stage IB1 (FIGO) initially treated with neoadjuvant chemotherapy, followed by radical surgery and cesarean section in the same surgical procedure.

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Neoadjuvant chemotherapy followed by radical surgery for Stage IB2 cervical cancer in pregnancy

European Journal of Gynaecological Oncology ◽

10.31083/j.ejgo.2020.03.5288 ◽

2020 ◽

Vol 41 (3) ◽

pp. 489

Keyword(s):

Cervical Cancer ◽

Neoadjuvant Chemotherapy ◽

Radical Surgery ◽

Cancer In Pregnancy ◽

In Pregnancy

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Radical Surgery After Neoadjuvant Chemotherapy for Locally Advanced Neuroendocrine Cancer of the Cervix

Anticancer Research ◽

10.21873/anticanres.15250 ◽

2021 ◽

Vol 41 (9) ◽

pp. 4431-4438

Author(s):

GIUSEPPE CARUSO ◽

INNOCENZA PALAIA ◽

VIOLANTE DI DONATO ◽

ANGELINA PERNAZZA ◽

ROBERTA GALLO ◽

...

Keyword(s):

Neoadjuvant Chemotherapy ◽

Radical Surgery ◽

Locally Advanced ◽

Neuroendocrine Cancer ◽

Cancer Of The Cervix

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Pregnant woman from southern Peru with rabies infection who delivered a healthy baby

Tropical Doctor ◽

10.1177/0049475520986050 ◽

2021 ◽

pp. 004947552098605

Author(s):

Arturo A Zarate ◽

Moises Sanchez ◽

Kevin Flores-Lovon ◽

Mercedes Tello ◽

Ericson L Gutierrez ◽

...

Keyword(s):

Intensive Care ◽

Pregnant Woman ◽

Respiratory Failure ◽

Cesarean Section ◽

High Mortality ◽

Premature Baby ◽

Healthy Baby ◽

Neurological Sequelae ◽

Emergency Cesarean ◽

In Pregnancy

Rabies in pregnancy is rare with a high mortality. We report a pregnant woman who developed urban rabies from the bite of an infected dog. An emergency Cesarean section was performed at 31 weeks of gestation, and a premature baby was delivered who survived and did not develop rabies. The mother, however, suffered a rapid clinical deterioration and was admitted to intensive care where a Milwaukee protocol was followed. The patient survived 19 months but developed severe neurological sequelae secondary to rabies encephalitis and finally died of respiratory failure.

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COVID-19 mRNA vaccine in pregnancy and newborn passive immunization: a case report

Future Science OA ◽

10.2144/fsoa-2021-0043 ◽

2021 ◽

Author(s):

Nadine El Kassis ◽

Wael Abdallah ◽

Rim Abou Chakra ◽

Wissam Arab ◽

Serge Sassine ◽

...

Keyword(s):

Case Report ◽

Pregnant Woman ◽

Cesarean Section ◽

Protective Effect ◽

Passive Immunization ◽

Prior History ◽

Case Presentation ◽

Maternal Vaccination ◽

History Of ◽

In Pregnancy

Aim: Evaluating the newborn passive immunization after maternal vaccination against SARS-COV-2. Case presentation: We present the case of a pregnant woman, with no prior history of COVID-19 infection, who got her second dose of mRNA vaccine against SARS-COV-2, 3 days before the start of her spontaneous labor. She was delivered by cesarean section after dynamical dystocia. Placental cord blood was retrieved immediately and sent to evaluate the titers of COVID-19 antibodies. Vaccine-generated antibodies were present in the umbilical cord with IgG spike >100 AU/ml. Conclusion: By reviewing the literature, vaccination seems to give hope about the potential protective effect of the maternal vaccination on her baby. Thus, pregnant women deserve a priority in the COVID-19 vaccination program.

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A Rare Cause of Hemoperitoneum in Pregnancy

Acta Médica Portuguesa ◽

10.20344/amp.12835 ◽

2022 ◽

Vol 35 (1) ◽

pp. 59

Author(s):

Ana Edral ◽

Carolina Da Costa Gomes ◽

Rita Martins ◽

Ângela Ferreira

Keyword(s):

Abdominal Pain ◽

Pregnant Woman ◽

Early Intervention ◽

Cesarean Section ◽

Rare Complication ◽

Hypovolemic Shock ◽

Posterior Surface ◽

Spontaneous Hemoperitoneum ◽

Poor Outcomes ◽

In Pregnancy

Spontaneous hemoperitoneum in pregnancy is a rare complication resulting in high maternal and fetal morbidity and mortality. The authors describe the case of a pregnant woman presenting at 32 weeks of gestation with abdominal pain and free abdominal fluid on ultrasound. Laparotomy revealed a hemoperitoneum resulting from a suspected ruptured varices on the uterine posterior surface. A live newborn was delivered by cesarean-section, and hemorrhage was controlled with sutures and compression. Clinicians should be aware of this diagnosis when a pregnant woman presents with abdominal pain, anemia or hypovolemic shock. Early intervention will avoid poor outcomes for both the mother and the fetus.

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Cervical Adenocarcinoma in Pregnancy with a Concomitant Papillary Adenocarcinoma of the Thyroid Gland: A Case Report

Surgical Case Reports ◽

10.31487/j.scr.2020.11.13 ◽

2020 ◽

pp. 1-3

Author(s):

Hornung René ◽

Nicole Bolla ◽

Katharina Putora ◽

Livia Noemi Kolb ◽

Hornung René

Keyword(s):

Thyroid Cancer ◽

Case Report ◽

Thyroid Gland ◽

Neoadjuvant Chemotherapy ◽

Papillary Thyroid Cancer ◽

Papillary Adenocarcinoma ◽

Cervical Adenocarcinoma ◽

Papillary Thyroid ◽

First Case ◽

In Pregnancy

Introduction: Cervical cancer in pregnancy is a rare disease, with an incidence of 0.01-0.1%, of which most are squamous epithelial cancers. We here present the first case of a uterine cervical adenocarcinoma during pregnancy with a concomitant papillary adenocarcinoma of the thyroid gland. Materials and Methods: Data were extracted from the patient’s records. Literature review was performed using the databases PubMed, Web of science and Embase. Case Report: A 36-year-old Gravida IV, Para III was admitted to the Cantonal Hospital St. Gallen, Switzerland with an invasive adenocarcinoma of the uterine cervix cT1B2 cNx Mx G1 ER neg PR neg Ki67 80% at 31 weeks of gestation. She was treated with 2 cycles of neoadjuvant chemotherapy (carboplatin and paclitaxel). Following caesarean section at 36 2/7 weeks of gestation, treatment was switched to chemoradiation therapy. The patient delivered a healthy girl. A concomitant papillary thyroid cancer pT1a, pN1a (1/6) was successfully treated by surgery. The patient is free of recurrence and metastasis at 4.5 years of follow-up for either of the tumors. Conclusion: Management of cervical cancers in pregnancy has to be individualized based on factors like gestational age, stage and histology of the cancer, and the wish for pregnancy continuation or termination. Neoadjuvant chemotherapy seems to be a reasonable option to postpone radical surgery or chemoradiotherapy to prevent preterm delivery. To the best of our knowledge, this is the first report of a cervical adenocarcinoma in pregnancy with a concomitant papillary thyroid cancer.

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Endometriosis and Risk of Adverse Pregnancy Outcome: A Systematic Review and Meta-Analysis

Journal of Clinical Medicine ◽

10.3390/jcm10040667 ◽

2021 ◽

Vol 10 (4) ◽

pp. 667

Author(s):

Kjerstine Breintoft ◽

Regitze Pinnerup ◽

Tine Brink Henriksen ◽

Dorte Rytter ◽

Niels Uldbjerg ◽

...

Keyword(s):

Preterm Birth ◽

Cesarean Section ◽

Placental Abruption ◽

Gestational Hypertension ◽

Adverse Pregnancy Outcome ◽

Placenta Previa ◽

Meta Analysis ◽

Increased Risk ◽

Spontaneous Hemoperitoneum ◽

In Pregnancy

Background: This systematic review and meta-analysis summarizes the evidence for the association between endometriosis and adverse pregnancy outcome, including gestational hypertension, pre-eclampsia, low birth weight, and small for gestational age, preterm birth, placenta previa, placental abruption, cesarean section, stillbirth, postpartum hemorrhage, spontaneous hemoperitoneum in pregnancy, and spontaneous bowel perforation in pregnancy. Methods: We performed the literature review in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA), by searches in PubMed and EMBASE, until 1 November 2020 (PROSPERO ID CRD42020213999). We included peer-reviewed observational cohort studies and case-control studies and scored them according to the Newcastle–Ottawa Scale, to assess the risk of bias and confounding. Results: 39 studies were included. Women with endometriosis had an increased risk of gestational hypertension, pre-eclampsia, preterm birth, placenta previa, placental abruption, cesarean section, and stillbirth, compared to women without endometriosis. These results remained unchanged in sub-analyses, including studies on spontaneous pregnancies only. Spontaneous hemoperitoneum in pregnancy and bowel perforation seemed to be associated with endometriosis; however, the studies were few and did not meet the inclusion criteria. Conclusions: The literature shows that endometriosis is associated with an increased risk of gestational hypertension, pre-eclampsia, preterm birth, placenta previa, placental abruption, cesarean section, and stillbirth.

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Neoadjuvant chemotherapy followed by radical surgery in locally advanced vulvar carcinoma: a single-institution experience

Tumori Journal ◽

10.1177/03008916211027627 ◽

2021 ◽

pp. 030089162110276

Author(s):

Adorni Marco ◽

Bazzurini Luca ◽

Lissoni Andrea Alberto ◽

Vecchione Francesca ◽

Negri Serena ◽

...

Keyword(s):

Overall Survival ◽

Neoadjuvant Chemotherapy ◽

Partial Response ◽

Vulvar Cancer ◽

Elderly Women ◽

Radical Surgery ◽

Locally Advanced ◽

Complete Response ◽

Tumor Burden ◽

Clinical Response Rate

Background: Squamous cell carcinoma of the vulva is a rare malignancy that affects elderly women. About one-third of vulvar cancers are diagnosed in an advanced stage, requiring extensive surgery. Neoadjuvant chemotherapy (NACT) has been introduced to reduce local tumor burden. In this retrospective study, we analyze the efficacy and toxicity of NACT followed by radical surgery. Methods: Patients with locally advanced vulvar cancer (LAVC) treated at our institution with neoadjuvant platinum and paclitaxel-based chemotherapy ± ifosfamide followed by surgery at our institution were retrospectively identified. Results: Fourteen patients (93%) completed NACT with tolerable toxicities (G3–G4 toxicity: 30%). Thirteen patients (87%) underwent surgery. The overall clinical response rate on vulvar disease was 66% (20% complete response, 46% partial response), confirmed by histopathologic analysis, while on inguinal lymph nodes it was 69% (23% complete response, 46% partial response). At the pathologic examination, all patients had negative surgical margins. Three out of 9 patients (33%) with lesions infiltrating the urethral meatus and 4 patients out of 7 (57%) with anal involvement did not require urethral amputation or colostomy, respectively, after NACT. No severe postoperative complications were described. Overall survival at 5 years was 60%, and median overall survival was 76 months. Conclusion: NACT followed by surgery in locally advanced vulvar cancer is well tolerated and allows surgical modulation.

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