Surgical interventions during pregnancy due to nontumor-like lesions and non-malignant and malignant genital cancers

Abstract

Aim: The aim of study was to evaluate the results of treatment in pregnant women with various pathologies and benign neoplasms of the genital organs which required surgical management. Material and methods: A retrospective analysis covered medical records of 33 pregnant women hospitalized in 1998-2017 operated on for pathologies affecting genital organs. The following parameters were assessed: age of patients, gestational age at the time of treatment, type of treatment, intraoperative histopathological diagnosis, and further course of pregnancy. Results: Gynecological pathologies were diagnosed in 33 out of 44 (75%) pregnant women undergoing surgical operations/procedures in the 20-year period. Those included one case of pre-invasive carcinoma of the uterine cervix in early pregnancy, two cases of mucous cystadenoma of borderline malignancy detected intraoperatively on histopathological examination. In 25 women, internal pathologies were operated on by laparotomy, and in two women by laparoscopy. Vaginal procedures and operations, i.e. ovarian and peri-salpingeal cyst punctures and cervical amputations were performed in 3 and 1 patient respectively. Serous, follicular, and corpus luteum ovarian cysts were the most numerous (11-33.3%) in the group of gynecological diseases. Operations for diseases and injuries of external genital organs were performed in 2 women. One of the women had a miscarriageon the 4th day after gynecological surgery. Another one left the Department with her pregnancy intact on the second day after surgery and did not report for further consultation. There were 3 (9.7%) premature births in 31 of 33 pregnant women operated on for gynecological diseases. Conclusions: Surgical treatment in pregnancy due to genital disorders should be individualized, taking into account clinical symptoms, gestational age, results of imaging and laboratory examinations, and the woman’s preferences. Surgical treatment due to gynecological diseases in pregnancy is associated with the risk of complications for the patient and obstetric failures such as miscarriages and premature births.