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Uterine evacuation with misoprostol during radiotherapy for cervical cancer in pregnancy
  1. K. OSTROM*,
  2. A. BEN-ARIE*,
  3. C. EDWARDS*,
  4. A. GREGG†,
  5. J.K. CHIU‡ and
  6. A. L. KAPLAN*
  1. * Gynecologic Oncology Division, Department of Obstetrics and Gynecology, Baylor College of Medicine, Houston, Texas
  2. †Maternal and Fetal Medicine Division, Department of Obstetrics and Gynecology, Baylor College of Medicine, Houston, Texas
  3. ‡Radiation Oncology Division, Department of Radiology, Baylor College of Medicine, Houston, Texas
  1. Address correspondence and reprint requests to: Kathryn Ostrom, MD, Dept. of Ob/Gyn, MSC 10-5580, One University of New Mexico, Albuquerque, NM, 87131. Email: kostrom{at}saluaunm.edu

Abstract

Radiotherapy as definitive treatment for invasive cervical cancer during pregnancy causes spontaneous abortion in most cases. Surgical evacuation of the uterus is indicated when abortion does not occur, exposing patients to additional morbidity. Two Latin American women, diagnosed with FIGO stage IB2 cervical cancer at approximately 15 weeks gestation, underwent radiotherapy with radiosensitizing chemotherapy. After intrauterine fetal demise was detected, both women underwent induction with misoprostol. Results included one complete abortion and one incomplete abortion without complications or delays in treatment. These cases demonstrate that induction with misoprostol appears to be a safe and effective alternative to surgical evacuation of the uterus when spontaneous abortion fails to occur during radiotherapy for locally advanced cervical cancer.

  • cervical cancer
  • misoprostol
  • pregnancy
  • radiotherapy

http://dx.doi.org/10.1136/ijgc-00009577-200305000-00013

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