Gynecology & Obstetrics
Open Access

Abstract

Late Midtrimester Pregnancy, Advanced Bulky Cervical Cancer, Radiation Therapy, and Physician's Moral Distress: A Management Dilemma

Radha Malapati, Olesya Brandis, Sameer Sharma and Tuan M. Nguyen

Background: Approximately 3% of cervical cancers are diagnosed during pregnancy, of which 75% are detected in early stages. The management may pose significant challenges because of the pregnant state.

Case: We describe a case of rapidly progressing bulky cervical cancer complicating a late second trimester pregnancy. The case was successfully managed by induction of labor with misoprostol after induced fetal demise followed by radiation therapy with fetus in situ.

Conclusion: In a late second trimester pregnancy complicated by rapidly progressing bulky cervical cancer, optimal outcome was achieved using a multidisciplinary approach. Fetal intra cardiac potassium chloride injection is helpful in the management of select cases.