Cervical Cancer in Pregnancy

Another Dilemma

Step 1: View clinicals

A 27 year old lady presents with vaginal bleeding and pelvic pain for 2 hours, which was of sudden onset. There was no history of abdominal trauma. She is currently at 22 weeks of amenorrhea of her first pregnancy, which has been uncomplicated so far. Her medical and drug histories are unremarkable.


Step 2: Order all relevant investigations

Cardiotocography

The baseline fetal heart rate is 150 bpm, with normal variability and periodic accelerations. There are no decelerations or evidence of uterine contractions.

Abdominopelvic Ultrasound

There is a mass measuring approximately 5 cm in diameter in the uterine cervix. No organ involvement is seen.

Colposcopy & Biopsy

Colposcopy: There is an exophytic bleeding mass with no vaginal involvement. Biopsy: Poorly differentiated squamous cell cancer.

Abdominopelvic MRI

There is a mass measuring 5x5x3 cm in size in the uterine cervix, with no parametrial infiltration. There is no pelvic lymphadenopathy.


Step 3: Select appropriate management

Urgent LSCS
Transfuse Blood
Radical Hysterectomy
IM Steroids Stat


Score: ★★☆