[Results]
During the study period, 12 pregnancies in ten women were included in
the VP group. In contrast, 19 pregnancies in 17 women were included in
the historical control group. Results from the comparison of the
oncological background characteristics of the ten women in the VP group
and 17 women in the historical control group, and the baseline maternal
characteristics of the 12 pregnancies in the VP group and 19 pregnancies
in the historical control group are shown in Table 1. The cancer stage
and operative procedures were similar in the two groups. Age at delivery
and the rate of assisted reproductive technology use were similar
between the two groups; one egg donation-embryo transfer was noted in
the VP group. The median duration between surgery and delivery was
somewhat longer in the VP group than in the control group, but the
difference was not statistically significant.
Table 2 shows the pregnancy and perinatal outcomes.
The incidence of preterm birth at
<37 weeks was 10/12 (83%) in the VP group and 11/19 (58%) in
the control group, and the incidence of preterm birth at <34
weeks was 6/12 (50%) in the VP group and 9/19 (47%) in the control
group. The difference in the incidence of preterm birth between the two
groups was similar and not statistically significant. The most common
cause of preterm emergency cesarean section was pPROM in both groups.
Figure 1 shows the distribution of gestational age at delivery in both
groups. The median gestational age at delivery was
33+6 weeks (range: 26+0 to
37+4 weeks) in the VP group and 34+6weeks (range: 23+5 to 37+5 weeks) in
the control group. No miscarriages (delivery <22 weeks)
occurred in either group. The incidence of pPROM was 6/12 (50%) in the
VP group and 8/19 (42%) in the control group. The median gestational
age at pPROM tended to be earlier in the VP group than in the control
group, although the difference was not statistically significant. In the
VP group, intrauterine fetal death occurred at 32 weeks of gestation in
one case. The fetal anatomic survey was unremarkable, and the cause of
fetal death was undetermined. Other pregnancy and perinatal outcomes
were similar between the two groups.
Table 3 shows the maternal adverse events. Of the total number of
pregnant women, abnormal massive vaginal bleeding from vaginal or
cervical varices during pregnancy occurred in eight women, and three
women from the VP group and four from the control group required blood
transfusion. In the control group, total abdominal hysterectomy (TAH)
after cesarean section was performed in two women. The indications for
TAH were placenta accreta in one and septic shock due to the development
of an intra-abdominal abscess following cesarean section in another. In
the VP group, no side effects of progesterone were noted.
Table S1 shows the neonatal outcomes of the 30 liveborn infants. In the
control group, an infant death occurred in one case. The birth weight,
number of admissions to the Neonatal Intensive Care Unit, and other
neonatal outcomes were similar in the two groups. Of the study
participants, 17 infants have already reached 1.5 years of corrected
age. Regarding neurodevelopmental outcomes, in the control group,
cerebral palsy was noted in one of the infants. None of the infants had
mental retardation or epilepsy.