Incidental Cervical Carcinoma Causing Obstructed Preterm Labor at 23 Weeks: A Case Report

Cervical cancer may remain undiagnosed during pregnancy in the absence of antenatal care, with potentially catastrophic obstetric consequences. We report an exceptionally rare case of an undiagnosed 5 cm cervical carcinoma discovered at 23 weeks of gestation, simultaneously obstructing the birth canal and complicated by chorioamnionitis-induced maternal sepsis. A 35-year-old multiparous woman (gravida 5 para 4) with a one-year history of uninvestigated post-coital metrorrhagia and no antenatal care presented at 23 weeks and 2 days with fever, pelvic pain, and watery vaginal discharge. Examination revealed sepsis with hemodynamic instability and a 5 cm indurated cervical mass with purulent leukorrhea; transvaginal ultrasound confirmed birth canal obstruction by the mass. An emergency cesarean section was performed, and a male neonate of 400 grams was delivered, dying two hours after birth from extreme prematurity. Cervical biopsies confirmed grade 2 squamous cell carcinoma (SCC); the patient was staged as International Federation of Gynecology and Obstetrics (FIGO) IIB and scheduled for radical hysterectomy and adjuvant chemoradiation. A cervical tumor can simultaneously obstruct labor and act as a nidus for ascending intrauterine infection, a dual mechanism not previously described. This case underscores the need for routine antenatal cervical examination and the urgent establishment of a national cervical cancer screening program aligned with international recommendations.