Cervical cancer and precancerous lesions in fertility patients and during pregnancy

Therapeutic management of patients who wish to conceive and who present with intraepithelial lesions of the cervix uteri can be challenging: high-grade squamous intraepithelial lesions (HSIL) should be ruled out before pregnancy, while excessive conization should be avoided with regard to the risks of sterility and unfavorable impact on obstetric outcome. Cervical cancer patients who wish to conceive can opt for trachelectomy and pelvic lymphadenectomy in case of FIGO IB1 <2 cm. In larger carcinoma, cisplatin-based neoadjuvant chemotherapy for downstaging is favorable. In pregnancy, dysplastic lesions must be distinguished from invasive carcinoma. Therapeutic management depends on tumor stage and trimester. Pelvic lymphonodectomy can be performed during pregnancy. In distinct cases, neoadjuvant chemotherapy is an option. © 2016, Springer-Verlag Berlin Heidelberg.