Κατεύθυνση Παθολογία της Κύησης
Library of the School of Health Sciences

2020-02-04

2020

Giannakas Panagiotis

Νικόλαος Παπαντωνίου, Ομότιμος Καθηγητής Ιατρικής Σχολής ΕΚΠΑ
Δημήτριος Κασσάνος, Ομότιμος Καθηγητής Ιατρικής Σχολής ΕΚΠΑ
Χαράλαμπος Χρέλιας, Αναπληρωτής Καθηγητής Ιατρικής Σχολής ΕΚΠΑ

Περιγεννητική Διαχείρηση Κύησης με HPV λοίμωξη και καρκίνο τραχήλου μήτρας

Greek

Perinatal management of women with HPV infection and cervical cancer

Introduction: The main causative factor for cervical cancer is the infection with on-cogenic types of HPVs (HR-HPVs). HPV infection, intraepithelial neoplasia, and cer-vical cancer are not too rare during pregnancy and should be under concern.
Aim of the Study: A review of the literature, with the aim to investigate and improve the management of HPV infection, precancerous and invasive lesions of cervical cancer during pregnancy and perinatal period.
Materials and Methods: A literature review was conducted using PubMed, Google Scholar, Medline, Cochrane Libraty to search for studies published between 1990 and 2019. The combinations of the following keywords were mainly used: Pregnancy, Perinatal, HPV, CIN, Carcinoma, Condyloma, JORRP, Vaccination, PET, Sentinel Lymph Node, Biopsy, Cytology, Colposcopy, Conization, LEEP, Radical, Surgery, Hysterectomy, Trachelectomy, Lymphadenectomy, Fertility-Sparing, Conservative, Cesarean, Chemotherapy, Radiotherapy, NACT, MIS, Obstetric, Oncological, Out-come.
Conclusions: HPV infection in pregnancy increases the risk for PROM, miscarriage, abnormal karyotype and JORRP. Genital warts increase the risk of infecting the baby with HPV. Wart treatment in pregnancy aims to reduce vertical transmission. The de-velopment of precancerous lesions during pregnancy is extremely rare and only fol-low-up is recommended. Conization is only permitted when microinvasion is suspect-ed. The treatment of cervical cancer in pregnancy (CCIP) still remains experimental, given the limited experience and the inability to conduct large prospective randomized trials. The main strategy in the perinatal period is to wait until neonatal maturity and start postpartum treatment. Conization can be applied to locally restricted cancer <2 cm in size and negative pelvic lymph nodes. In more extensive tumors, platinum-based neoadjuvant therapy is considered safe and reduces the disease until childbirth. CC is recommended for all women with CCIP and can reduce transmission rates on the presence of warts, while in other cases it does not play a protective role and should not be routinely recommended. For the time being, the only solution to reduce the incidence of HPV and its complications during pregnancy is the establishment of universal vaccination of the population against HPV.

Health Sciences

Pregnancy, Perinatal, HPV, CIN, Carcinoma, Condyloma, JORRP, Vaccination, PET, Sentinel Lymph Node, Biopsy, Cytology, Colposcopy, Conization, LEEP, Radical, Surgery, Hysterectomy, Trachelectomy, Lymphadenectomy, Fertility-Sparing, Conservative, Cesarean, Chemotherapy, Radiotherapy, NACT, MIS, Obstetric, Oncological, Outcome

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https://pergamos.lib.uoa.gr/uoa/dl/object/2896587