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Use of an Arabin pessary to prevent preterm birth in pregnancy complicated by a short cervix after cervical conization for cervical adenocarcinoma with residual disease: A case report and literature review

Surgical conization of the cervix for cervical cancer increases the risk of preterm birth in subsequent pregnancies. The ideal intervention to prevent preterm births in women with cervical insufficiency resulting from conization is not known. When histological margins of the cone biopsy are suspecte...

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Autores principales: Teoh, Jessica, Pather, Selvan, Narayan, Rajit
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9385544/
https://www.ncbi.nlm.nih.gov/pubmed/35991521
http://dx.doi.org/10.1016/j.crwh.2022.e00437
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author Teoh, Jessica
Pather, Selvan
Narayan, Rajit
author_facet Teoh, Jessica
Pather, Selvan
Narayan, Rajit
author_sort Teoh, Jessica
collection PubMed
description Surgical conization of the cervix for cervical cancer increases the risk of preterm birth in subsequent pregnancies. The ideal intervention to prevent preterm births in women with cervical insufficiency resulting from conization is not known. When histological margins of the cone biopsy are suspected to have residual malignancy, surveillance and oncological management during a concurrent pregnancy can be challenging. This case outlines the management of a pregnancy complicated by a short cervix secondary to conization for adenocarcinoma of cervix, with margins suspected to be not clear of disease. The patient had progressive shortening of the cervix despite vaginal progesterone, but maintained a cervical length of 16 mm following Arabin pessary insertion. She delivered a healthy neonate at 34 + 3 weeks of gestation (105 days following pessary insertion). The cervical pessary in combination with vaginal progesterone may be safe and effective in preventing preterm birth in a pregnancy with possible residual cervical cancer and a short cervix.
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spelling pubmed-93855442022-08-19 Use of an Arabin pessary to prevent preterm birth in pregnancy complicated by a short cervix after cervical conization for cervical adenocarcinoma with residual disease: A case report and literature review Teoh, Jessica Pather, Selvan Narayan, Rajit Case Rep Womens Health Article Surgical conization of the cervix for cervical cancer increases the risk of preterm birth in subsequent pregnancies. The ideal intervention to prevent preterm births in women with cervical insufficiency resulting from conization is not known. When histological margins of the cone biopsy are suspected to have residual malignancy, surveillance and oncological management during a concurrent pregnancy can be challenging. This case outlines the management of a pregnancy complicated by a short cervix secondary to conization for adenocarcinoma of cervix, with margins suspected to be not clear of disease. The patient had progressive shortening of the cervix despite vaginal progesterone, but maintained a cervical length of 16 mm following Arabin pessary insertion. She delivered a healthy neonate at 34 + 3 weeks of gestation (105 days following pessary insertion). The cervical pessary in combination with vaginal progesterone may be safe and effective in preventing preterm birth in a pregnancy with possible residual cervical cancer and a short cervix. Elsevier 2022-08-05 /pmc/articles/PMC9385544/ /pubmed/35991521 http://dx.doi.org/10.1016/j.crwh.2022.e00437 Text en © 2022 The Authors https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
spellingShingle Article
Teoh, Jessica
Pather, Selvan
Narayan, Rajit
Use of an Arabin pessary to prevent preterm birth in pregnancy complicated by a short cervix after cervical conization for cervical adenocarcinoma with residual disease: A case report and literature review
title Use of an Arabin pessary to prevent preterm birth in pregnancy complicated by a short cervix after cervical conization for cervical adenocarcinoma with residual disease: A case report and literature review
title_full Use of an Arabin pessary to prevent preterm birth in pregnancy complicated by a short cervix after cervical conization for cervical adenocarcinoma with residual disease: A case report and literature review
title_fullStr Use of an Arabin pessary to prevent preterm birth in pregnancy complicated by a short cervix after cervical conization for cervical adenocarcinoma with residual disease: A case report and literature review
title_full_unstemmed Use of an Arabin pessary to prevent preterm birth in pregnancy complicated by a short cervix after cervical conization for cervical adenocarcinoma with residual disease: A case report and literature review
title_short Use of an Arabin pessary to prevent preterm birth in pregnancy complicated by a short cervix after cervical conization for cervical adenocarcinoma with residual disease: A case report and literature review
title_sort use of an arabin pessary to prevent preterm birth in pregnancy complicated by a short cervix after cervical conization for cervical adenocarcinoma with residual disease: a case report and literature review
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9385544/
https://www.ncbi.nlm.nih.gov/pubmed/35991521
http://dx.doi.org/10.1016/j.crwh.2022.e00437
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