In 2018, Australian media briefly turned its eye to two babies, Vander Clark and Baxter Browne, and the remarkable circumstances around their births.
Their mothers, Jenna-Lea Clark and Kirsty Browne, had both been treated for cervical cancer. Instead of undergoing hysterectomies (the usual approach which involves removing the cervix and uterus), Jenna-Lea and Kirsty both opted for trachelectomies.
A trachelectomy involves the removal of the cervix and lymph nodes, but the body of the uterus is retained and attached to the top of the vagina.
“This gives women at least the opportunity to carry a child,” said Dr Trevor Tejada-Berges, gynaecologic oncologist and Kirsty’s surgeon.
“Over the last 10 to 20 years, there have been increasing numbers of women who have had a trachelectomy,” Trevor said.
“It carries surgical risks. It carries the possibility of pain, discomfort from the surgery, irregular bleeding … There is still a concern of prematurity in pregnancy. There is a high risk of miscarrying. So a lot of women still don’t pursue it.”
“But even being able to provide that option, where the doors have not completely shut, goes a long way towards making women feel comfortable.”
Throughout Kirsty’s pregnancy following her surgery, Trevor worked with RPA’s foetal medicine team to monitor her progress.
“It was such a unique situation,” he said. “It involved referring to them early on, when she was thinking of becoming pregnant. There was prenatal consultation. They would call me and discuss the case.”
“We would have conversations about how things are going, what to do. When there were any complications, we would ask if they were related to the surgery.”
“I think there can be a tendency to silo care … This was a good collaboration.”
“Kirsty was also a part of that. She was very proactive, emailing with any questions she had.”
Trevor stayed involved throughout the pregnancy, even to the point of being present in the delivery room.
“As a gynae-oncologist, so much of what we do is destructive. It’s about taking out a uterus that has cancer or removing the ovaries if there’s a risk of cancer,” he said.
“To actually do something that is both curative and offers a level of restoration of normalcy was really nice for us.