USMLE Step 2 CK Lecture Notes 2019: Obstetrics/Gynecology (Kaplan Test Prep)

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postpartum.
Microinvasion. Patients with microinvasive cervical cancer on biopsy during
pregnancy should be evaluated with cone biopsy to ensure no frank invasion.
If the cone biopsy specimen shows microinvasive carcinoma during
pregnancy, these patients can also be followed conservatively, delivered
vaginally, reevaluated, and treated two months postpartum.
Invasive cancer. If the punch biopsy of the cervix reveals frankly invasive
carcinoma, then treatment is based on the gestational age.
In general, if a diagnosis of invasive carcinoma is made before 24
weeks of pregnancy, the patient should receive definitive treatment (e.g.,
radical hysterectomy or radiation therapy).
If the diagnosis is made after 24 weeks of pregnancy, then conservative
management up to about 32–33 weeks can be done to allow for fetal
maturity to be achieved, at which time cesarean delivery is performed and
definite treatment begun.

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