Cervical Cancer during Pregnancy: Management and Maternal and Perinatal Outcomes

• Cervical cancer screening should be performed even during pregnancy. • Most of the pregnant women were diagnosed with locally advanced cervical cancer. • Neoadjuvant chemotherapy improves maternal outcomes and reduces the risk of extreme prematurity. • Prenatal care must be provided in tertiary centers by a multidisciplinary and multiprofessional team. The incidence of cervical cancer during pregnancy ranges from 1.5 to 12 cases per 100,000 pregnancies. Due to its rarity, the management of this population is based on case series and expert opinions. This study aimed to share our experience in the care of pregnant women diagnosed with cervical cancer, focusing on treatment approaches, obstetric and perinatal outcomes, and maternal survival. This prospective cohort study included pregnant women with cervical cancer admitted to our institution between January 2013 and December 2023. We analyzed patient age, clinical stage, oncologic treatment during pregnancy and postpartum, survival rates, and obstetric and perinatal outcomes. A total of 30 patients were included, with an average age of 31.6 years (20–43 years). Squamous cell carcinoma was observed in 73.3% of the patients, and 66.7% of the patients presented locally advanced cancer. During pregnancy, 53.8% of the patients received neoadjuvant chemotherapy and 15.38% (4/26) underwent conization. The average gestational age (GA) at delivery was 35.8 weeks, with 61.5% of deliveries occurring preterm (GA <37 weeks). The average birth weight was 2,575.88 g. Following pregnancy, of the 30 patients, 22 (73.33%) received platinum-based chemotherapy and radiotherapy, while two (6.66%) received only chemotherapy. Regarding overall survival, the average follow-up period was 35.8 months (5.99–99.24 months). The overall survival rates were 94.4% at 12 months, 82.6% at 18 months, and 62% at 24 months. In this study, most of the pregnant women were diagnosed with locally advanced cervical cancer, highlighting the importance of cervical cancer screening even during pregnancy. Neoadjuvant chemotherapy allowed the pregnancy to be prolonged and reduced the risk of extreme prematurity. However, more studies are necessary to reach definitive conclusions. Prenatal care must be provided in tertiary centers by a multidisciplinary and multiprofessional team to optimize maternal and perinatal outcomes and increase maternal survival.