Management of cervical cancer detected during pregnancy: Role of magnetic resonance imaging

Objective: The aims of the present study were to assess the role of magnetic resonance imaging (MRI) in the staging and follow-up of uterine cervical cancers discovered during pregnancy and to evaluate the role of MRI in decision making regarding treatment options for patients with uterine cervical cancer during pregnancy. Method: Twelve pregnant women with cervical cancer were included. Two populations of patients were distinguished: localized cervical cancer discovered on the Pap smear during the first trimester of pregnancy, at an early stage (n=5), and invasive cervical cancer revealed later, during the second or third trimester (n=7). Abdominal and pelvic MRI sequences were acquired with a phased-array coil. Magnetic resonance results were correlated with the physical examination, Pap smear, and pathology. Results: In the first population, MRI was normal or detected a small lesion (stage IB1), and pregnancies were allowed to continue. In the second population, MRI detected a lesion in every case (mean size, 62 mm; 30-110 mm), and positive lymph nodes were depicted in 2 cases. The pregnancy was interrupted in four patients: one interruption in localized cervical cancer group and three in invasive cervical group). In all other cases, a cesarean section was done after the 30th week. In one case, MRI assessed response after chemotherapy administered during pregnancy. Conclusion: MRI is an essential examination for planning the treatment of cervical cancers diagnosed during pregnancy.