Objective To determine whether vaginal progesterone (VP) reduces the rate of preterm birth in pregnant women after abdominal trachelectomy (AT) for early-stage cervical cancer Design Prospective cohort study with a historical cohort Setting University hospital Population Twelve pregnancies in ten women were included in the VP group between October 2016 and September 2020. By contrast, 19 pregnancies in 17 women were included in the historical control group between January 2007 and September 2016. Methods For the interventional study participants, the administration of vaginal progesterone was started between 16+0 and 19+6 weeks of gestation and discontinued at 34 weeks of gestation or at the time of delivery, rupture of membranes, or massive uterine bleeding, whichever occurred first. We investigated obstetric and neonatal outcomes among the study participants and compared them with outcomes of the historical control group participants. Main Outcome Measures The gestational age at delivery and incidence of preterm birth before 37 weeks and 34 weeks of gestation Results 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 incidence of preterm birth in the two groups was similar, and the difference between the two groups was not statistically significant. Conclusions The administration of vaginal progesterone did not reduce the rate of preterm birth among pregnant women after AT.

Background In cervical cancer, the benefits of sentinel lymph node biopsy (SLNB) have long been confined by the lack of precise intraoperative pathological examination. Objective To determine the diagnostic performance and optimal protocol of frozen section examination (FSE) in SLNB for cervical cancer. Search Strategy PubMed, EMBASE, Web of Science, Cochrane Library, Wanfang Data and China National Knowledge Infrastructure were searched from inception to July 30, 2019. Selection Criteria Studies reporting the data of SLNB combined with FSE in cervical cancer were included. Data Collection and Analysis Two independent reviewers extracted the data. Bivariate mixed-effects regression model was applied for analyses. Sensitivity of FSE in detecting SLN metastasis was the primary diagnostic indicator for evaluation. Main Results The pooled sensitivity of FSE among 31 eligible studies (1887 patients) was 0.77 (95% CI 0.66–0.85) with high heterogeneity (I2=69.73%). Two representative FSE protocols were identified from 26 studies, described as equatorial (E-protocol, SLN was bisected) and latitudinal (L-protocol, SLN was cut at intervals). Meta-regression showed that FSE protocol was the only source of heterogeneity (p<0.001). The pooled sensitivity was 0.86 (95% CI 0.79–0.91, I2=0%) and 0.59 (0.46–0.72, I2=58.47%) for FSE using L- and E- protocol, respectively. The pooled sensitivity of FSE using L-protocol would reach 0.97 (0.89–0.99) if only marcometastases were considered. These findings were robust to sensitivity analyses. Conclusions With L-protocol, FSE can provide precise intraoperative pathology for SLNB, which enables immediate decision-making for individualized managements. Keywords Cervical cancer, sentinel lymph node, metastasis, frozen section, sensitivity, meta-analysis.