A 32-year-old Japanese woman was diagnosed as having stage Ib1
adenocarcinoma by diagnostic
laser conization at a local hospital. She was admitted to our hospital for fertility-sparing treatment. A radical
trachelectomy (RT) was performed using the laparoscopic vaginal procedure. The procedure was started with a laparoscopic pelvic
lymphadenectomy. As the lymph nodes were
tumor free, RT was carried out transvaginally. The excised uterine cervix and lymph nodes were pathologically negative for
cancer. Eight months after the operation, the patient became pregnant without any artificial reproduction techniques.
At 17 weeks of gestation, she was admitted to our hospital again for a
threatened abortion. Continuous
tocolytic treatment with
ritodrine and daily administration of a
granulocyte elastase inhibitor
vaginal suppository were given. At 32 weeks of gestation, she underwent emergency
cesarean section because of sudden premature
rupture of the membranes. A girl weighing 1991 g was delivered, with Apgar scores of 7 and 8 at 1 and 5 min, respectively. Both the mother and the baby were discharged without trouble. This is the first successful case in Japan of delivery after vaginal RT for invasive
uterine cervical cancer.