On May 10, 2021, a premature infant delivered by a female patient with cervical squamous cell carcinoma was recovered and discharged from hospital.
A female patient, surnamed Zhang, who was diagnosed with cervical squamous cell carcinoma, became pregnant naturally in 2020. On February 20, 2021, she was admitted to the First Affiliated Hospital of Xi’an Jiaotong University (XJTU) due to premature rupture of membrane and successfully underwent emergency cesarean section.On the afternoon of May 10, the premature infant with a gestational age of only 27 weeks+1was recovered and discharged after 78-day treatment. This is the first case of successful natural pregnancy and childbirth after cervical cancer surgery in our hospital, which is also rarely reported in Northwest China.
The patient was diagnosed with cervical squamous cell carcinoma 7 years ago. According to the description of Professor Zou Yuliang from Department of Obstetrics and Gynecology, after comprehensive preoperative examinations, a multi-disciplinary team (MDT) consultation was delivered for this patient to assess the size of lesions, determine the design of surgical plan and discuss the cooperation during surgical procedures. On December 5, 2014, Professor Zou Yuliang served as the Chief Surgeon to successfully perform reproductive function-preserved total laparoscopic extensive cervical resection combined with lymph node dissection.
After the operation, Professor Zou Yuliang delivered persistent guidance on postoperative recovery to the patient. Surprisingly, she became pregnant naturally in September, 2020. She is the first patient who can conceive naturally after cervical cancer surgery and reach the gestational age of over 27 weeks ever encountered in our hospital.
During the whole stages of pregnancy, the patient began to frequently present with signs of abortion in the first trimester of pregnancy, such as vaginal bleeding and cervical canal shortening. Due to living in Yan’an and the specific physical conditions, she could not come to our hospital whenever necessary. To maximize the safety of the mother and infant, Professor Zou Yuliang and Professor Song Qing from Department of Obstetrics provided guidance and follow-up to the maternal situation during the whole stages of pregnancy. In addition, prestigious experts in relevant fields in Shaanxi province were also invited for joint consultation and discussion to guarantee the maternal and infantile safety.
On February 20, 2021, the patient accidentally developed premature rupture of membrane. B-ultrasound prompted that the maximum depth of amniotic fluid was only 1.1 cm, accompanied by hypothyroidism and placental depression,etc. She was in an extremely critical condition. Under the assistance from Professor Zou Yuliang and Associate Professor Bao Lijun, a fast-track labor channel was immediately established for the patient. Professor Song Qing from Department of Obstetrics and her team members immediately performed cesarean section. A premature boy was safely delivered, whereas all indicators of the infant were basically normal. The infant was immediately transferred to Department of Neonatology for subsequent treatment.
After 78-day treatment in Department of Neonatology, the body weight was increased from 910 g to over 3500 g. Under the attentive and professional care of the team led by Deputy Director Song Hongxia, the premature infant with extremely-low body weight overcame the respiratory, infection and feeding challenges, and was eventuallydischarged after full recovery.
