Welcome to the ePoster Viewing Panel of AICOG 2025

Introduction: Cancer cervix is the most frequently occuring gynecological malignancy during pregnancy with incident rate of 0.1- 12 per 10,000 pregnancies. Because of the pregnancy-related hormonal changes and the involvement of the reproductive organs, cervical cancer management during pregnancy is very difficult. Case presentation: 31 years old G3P2L1 at 38 weeks 5days Period of Gestation known case of Carcinoma cervix reported to with complaints of leaking per vagina in the month of July 2024. Patient had regular ANC?s in Kasargod. On examination , per abdomen uterus ~ term size, cephalic presentation, 2 contractions lasting for 30 seconds in 10 minutes. Per speculum examination, proliferative, friable growth of 4 x 4 cms seen occupying whole of the cervix. Cervical biopsy done on 29/6/2024 showed Poorly differentiated non keratinising squamous cell carcinoma NOS. Patient underwent LSCS in view of Cervical carcinoma in active stage of labour. Post LSCS MRI PELVIS done showed altered signal intensity area showing diffusion restriction and heterogenous post contrast enhancement measuring 2.9*1.6*2.9 cm epicentered in the cervix predominantly in the anterior and right lateral wall extending to the posterior wall of lower cervix. No evidence of extension to the rest of the uterus and vagina. No evidence of parametrial invasion. Evidence of few lymph nodes diffusion restriction noted in the right external iliac region largest measuring 9*7 mm. Uterus is bulky postpartum status. Endometrial thickness 8.5 mm. Bilateral ovaries normal. Clinico radiological staging -Stage IIIC1 (FIGO). Patient was adviced to follow up for radiotherapy. Discussion: Hormonal changes can often mask the symptoms of cervical cancer, routine prenatal screening has resulted in a detection rate of over 70%. However, there remains a risk of mistaking cervical cancer symptoms for normal pregnancy-related or benign conditions, leading to delayed diagnosis. Consequently, pregnant and postpartum women should remain vigilant for signs such as irregular vaginal bleeding or unusual vaginal discharge (bloody, purulent, or foul-smelling discharge). Pelvic examination and cytology are valuable tools for identifying asymptomatic cervical cancer. As a result, Patients who have not participated in previous screening programs should prioritize the first prenatal visit. If cervical cancer is detected before the 20th week of pregnancy, the usual recommendation is to terminate the pregnancy. However, the risks associated with specific treatments vary depending on the stage of pregnancy. Conclusion : Treating cancer in pregnant women is undeniably a significant challenge. Limited experience in diagnosing and managing malignancies during pregnancy can result in delays or inappropriate treatment, posing risks to both the mother and the fetus. Current literature does not provide standardized treatment protocols, relying instead on general guidelines and small case studies. Therefore, A multidisciplinary team of specialists, consisting of obstetricians, gynecologists, neonatologists, and oncologists, should be assembled to handle pregnant women diagnosed with cervical cancer. Future clinical research should address these challenges to improve care for pregnant patients with cancer.