Pregnancy after trachelectomy: a high-risk condition of preterm delivery. Report of a case and review of the literature

Background. Trachelectomy is a conservative but locally radical procedure associated with a high risk of preterm delivery. Case. A 28-year-old patient with cervical cancer FIGO stage IB1 was treated with laparoscopic pelvic lymphadenectomy followed by trachelectomy. Three years later, she conceived spontaneously. In consideration of the high risk of preterm delivery, the cervical status was evaluated by transvaginal ultrasonography. At 16 weeks' gestation, we observed the cerclage suture correctly placed at the level of the internal cervical os and a neo-cervical segment length of 1.5 cm. Thereafter, serial ultrasound measurements showed preservation of the cervical competence. The patient achieved an uneventful pregnancy and delivered by elective cesarean section at 37 weeks. Conclusion. Transvaginal scans to evaluate the competence of the neo-cervix may contribute to the management and counseling of patients after trachelectomy. (C) 2004 Elsevier Inc. All rights reserved.