Chapters authored
Management of Cervical Cancer and Human Papillomavirus in Pregnancy
Cervical cancer during pregnancy is the most commonly detected malignant tumor. It has become a public health problem, 99% related to human papillomavirus (HPV) infection, making it the only gynecological malignant tumor of clear etiology in the world. It is diagnosed at any stage of pregnancy. Its initial presentation is observed as transvaginal bleeding in all three trimesters associated with HPV infection. If the metastasis is negative in the lymph nodes, it improves. At an early stage the prognosis is favorable, management consists of preserving pregnancy, neoadjuvant chemotherapy can be used to treat cervical cancer in pregnancy, in cases of viable pregnancies between 27- and 31-weeks’ gestation chemotherapy may be performed depending on the staging, caesarean section at 35 weeks, radical surgery and systemic chemotherapy may achieve good results depending on the stage of the tumor.
Part of the book: Women's Health Updates
Alteration of Fetal Growth
Fetal growth is a process that is not easy to assess and is regulated by multiple mechanisms that depend on many fetal, placental, and maternal factors. The birth weight percentile compared to the estimated gestational age reveals lower gestational ages for women and higher gestational ages for men in certain geographic areas such as Africa, with differences in comparison with the world population. The alteration in fetal growth is related to several perinatal complications such as intrauterine death, increased cesarean section, maternal-neonatal injuries, and shoulder dystocia. Among the main manifestations of fetal growth disturbance is intrauterine fetal growth restriction, which affects approximately 3–7% of all pregnancies and is defined as a condition in which the fetus fails to achieve the growth determined by its genetic makeup. Its diagnosis requires an estimated fetal weight by ultrasound lower than the 10th percentile for gestational age. The most outstanding maternal risk factor for fetal growth disturbance is maternal body mass index, where obesity predominates. Asymmetric or type II intrauterine growth restriction is more frequent in the second trimester of pregnancy.
Part of the book: Reproductive and Gynecologic Health Annual Volume 2025