Stage 1A2 cervical cancer detected at 26 weeks of pregnancy. Next line of management is –

Correct Answer: Classical c. section followed by Wertheim's hysterectomy at 30-32 weeks
Description: Ans. is 'c' i.e., Classical c. section followed by Wertheim's hysterectomy at 30-32 weeks Treatment modalities for Ca cervix are the same as in non pregnant women* Stage 1A1:# Vaginal delivery and then simple extrafascial hysterectomy or therapeutic conization after 6 weeks postpartum* Stage 1A2, IB, 2A:# If detected in first trimester = immediate Wertheim's hysterectomy on pregnant uterus.# If detected in late second or third trimester (as in this MCQ) : wait (treatment can be delayed up to 4-6 weeks) for fetal lung maturity and then classical caesarean section followed immediately by Wertheim's hysterectomy.# So, option c) is the answer* Stage 2B-4:# If detected in first trimester: immediate radiotherapy# If detected in late second or third trimester: wait for fetal maturity, classical caesarean section and then radiotherapy after 4 weeks.
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