ABSTRACTObjectiveTo investigate the performance of severe smallness in the prediction of adverse perinatal outcome among fetuses with suspected late‐onset small‐for‐gestational age (SGA).MethodsA systematic search was performed to identify relevant studies in PubMed, Web of Science and Scopus. Late‐onset SGA was defined as estimated fetal weight (EFW) or abdominal circumference (AC) < 10th percentile diagnosed at or after 32 weeks' gestation, while severe SGA was defined as EFW or AC < 3rd percentile or < 2 SD. Random‐effects modeling was used to generate hierarchical summary receiver‐operating‐characteristics (HSROC) curves. The performance of severe SGA (as a presumptive diagnosis) in predicting adverse perinatal outcome among singleton pregnancies with suspected late‐onset SGA was expressed as area under the HSROC curve (AUC), sensitivity, specificity and positive/negative likelihood ratios. The association between suspected severe SGA and adverse perinatal outcome was also assessed by random‐effects modeling using the Mantel–Haenszel method and presented as odds ratio (OR). The non‐exposed group was defined as non‐severe SGA (EFW ≥ 3rd centile).ResultsTwelve cohort studies were included in this systematic review and meta‐analysis. The studies included a total of 3639 fetuses with suspected late‐onset SGA, of which 1246 had suspected severe SGA. Significant associations were found between suspected severe SGA and composite adverse perinatal outcome (OR, 1.97 (95% CI, 1.33–2.92)), neonatal intensive care unit admission (OR, 2.87 (95% CI, 1.84–4.47)) and perinatal death (OR, 4.26 (95% CI, 1.07–16.93)). However, summary ROC curves showed limited performance of suspected severe SGA in predicting perinatal outcomes, with AUCs of 60.9%, 66.9%, 53.6%, 57.2%, 54.6% and 64.9% for composite adverse perinatal outcome, neonatal intensive care unit admission, neonatal acidosis, Cesarean section for intrapartum fetal compromise, low Apgar score and perinatal death, respectively.ConclusionAlthough suspected severe SGA was associated with a higher risk of perinatal complications, it performed poorly as a standalone parameter in predicting adverse perinatal outcome. © 2022 International Society of Ultrasound in Obstetrics and Gynecology.

ABSTRACT Objective To develop a model for the prediction of adverse perinatal outcome in growth‐restricted fetuses requiring delivery before 28 weeks in order to provide individualized patient counseling. Methods This was a retrospective multicenter cohort study of singleton pregnancies with antenatal suspicion of fetal growth restriction requiring delivery before 28 weeks' gestation between January 2010 and January 2020 in six tertiary public hospitals in the Barcelona area, Spain. Separate predictive models for mortality only and mortality or severe neurological morbidity were created using logistic regression from variables available antenatally. For each model, predictive performance was evaluated using receiver‐operating‐characteristics (ROC)‐curve analysis. Predictive models were validated externally in an additional cohort of growth‐restricted fetuses from another public tertiary hospital with the same inclusion and exclusion criteria. Results A total of 110 cases were included. The neonatal mortality rate was 37.3% and, among the survivors, the rate of severe neurological morbidity was 21.7%. The following factors were retained in the multivariate analysis as significant predictors of mortality: magnesium sulfate neuroprotection, gestational age at birth, estimated fetal weight, male sex and Doppler stage. This model had a significantly higher area under the ROC curve (AUC) compared with a model including only gestational age at birth (0.810 (95% CI, 0.730–0.889) vs 0.695 (95% CI, 0.594–0.795); P = 0.016). At a 20% false‐positive rate, the model showed a sensitivity, negative predictive value and positive predictive value of 66%, 80% and 66%, respectively. For the prediction of the composite adverse outcome (mortality or severe neurological morbidity), the model included: gestational age at birth, male sex and Doppler stage. This model had a significantly higher AUC compared with a model including only gestational age at birth (0.810 (95% CI, 0.731–0.892) vs 0.689 (95% CI, 0.588–0.799); P = 0.017). At a 20% false‐positive rate, the model showed a sensitivity, negative predictive value and positive predictive value of 55%, 63% and 74%, respectively. External validation of both models yielded similar AUCs that did not differ significantly from those obtained in the original sample. Conclusions Estimated fetal weight, fetal sex and Doppler stage can be combined with gestational age to improve the prediction of death or severe neurological sequelae in growth‐restricted fetuses requiring delivery before 28 weeks. This approach may be useful for parental counseling and decision‐making. © 2023 International Society of Ultrasound in Obstetrics and Gynecology.

BJOG: An International Journal of Obstetrics & GynaecologyVolume 130, Issue 6 p. 688-689 LETTERS TO THE EDITOR Prognosis of periviable early-fetal growth restriction: Gaining accuracy E. Meler, Corresponding Author E. Meler [email protected] orcid.org/0000-0002-5975-9834 Barcelona Centre for Maternal-Fetal and Neonatal Medicine (Hospital Clínic and Hospital Sant Joan de Déu), Institut d'Investigacions Biomèdiques August Pi I Sunyer (IDIBAPS), Centre for Biomedical Research on Rare Diseases (CIBER-ER), Hospital Clínic, Universitat de Barcelona, Barcelona, Spain Correspondence E. Meler, Barcelona Centre for Maternal-Fetal and Neonatal Medicine (Hospital Clínic and Hospital Sant Joan de Déu), Institut d'Investigacions Biomèdiques August Pi I Sunyer (IDIBAPS), Universitat de Barcelona, Centre for Biomedical Research on Rare Diseases (CIBER-ER), Hospital Clínic, Carrer Sabino de Arana 1, 08028 Barcelona, Spain. Email: [email protected]Search for more papers by this authorE. Mazarico, E. Mazarico Barcelona Centre for Maternal-Fetal and Neonatal Medicine (Hospital Clínic and Hospital Sant Joan de Déu), Institut de Recerca Sant Joan de Déu (IR-SJD), Barcelona, Spain Maternal and Child Health Development Network, RETICS (Redes Temáticas de Investigación Cooperativa en Salud), Research Institute Carlos III, Spanish Ministry of Economy and Competitiveness, Madrid, SpainSearch for more papers by this authorA. Peguero, A. Peguero Barcelona Centre for Maternal-Fetal and Neonatal Medicine (Hospital Clínic and Hospital Sant Joan de Déu), Institut d'Investigacions Biomèdiques August Pi I Sunyer (IDIBAPS), Centre for Biomedical Research on Rare Diseases (CIBER-ER), Hospital Clínic, Universitat de Barcelona, Barcelona, SpainSearch for more papers by this authorA. Gonzalez, A. Gonzalez Barcelona Centre for Maternal-Fetal and Neonatal Medicine (Hospital Clínic and Hospital Sant Joan de Déu), Institut de Recerca Sant Joan de Déu (IR-SJD), Barcelona, Spain Maternal and Child Health Development Network, RETICS (Redes Temáticas de Investigación Cooperativa en Salud), Research Institute Carlos III, Spanish Ministry of Economy and Competitiveness, Madrid, SpainSearch for more papers by this authorJ. Martinez, J. Martinez orcid.org/0000-0001-9837-3822 Barcelona Centre for Maternal-Fetal and Neonatal Medicine (Hospital Clínic and Hospital Sant Joan de Déu), Institut d'Investigacions Biomèdiques August Pi I Sunyer (IDIBAPS), Centre for Biomedical Research on Rare Diseases (CIBER-ER), Hospital Clínic, Universitat de Barcelona, Barcelona, SpainSearch for more papers by this authorD. Boada, D. Boada Barcelona Centre for Maternal-Fetal and Neonatal Medicine (Hospital Clínic and Hospital Sant Joan de Déu), Institut d'Investigacions Biomèdiques August Pi I Sunyer (IDIBAPS), Centre for Biomedical Research on Rare Diseases (CIBER-ER), Hospital Clínic, Universitat de Barcelona, Barcelona, SpainSearch for more papers by this authorK. Vellve, K. Vellve Barcelona Centre for Maternal-Fetal and Neonatal Medicine (Hospital Clínic and Hospital Sant Joan de Déu), Institut d'Investigacions Biomèdiques August Pi I Sunyer (IDIBAPS), Centre for Biomedical Research on Rare Diseases (CIBER-ER), Hospital Clínic, Universitat de Barcelona, Barcelona, SpainSearch for more papers by this authorG. Arca, G. Arca Department of Neonatology, Hospital Clinic, IDIBAPS, Barcelona, Spain Neonatal Group, NeNE Foundation, Barcelona, SpainSearch for more papers by this authorM. D. Gómez-Roig, M. D. Gómez-Roig Barcelona Centre for Maternal-Fetal and Neonatal Medicine (Hospital Clínic and Hospital Sant Joan de Déu), Institut de Recerca Sant Joan de Déu (IR-SJD), Barcelona, Spain Maternal and Child Health Development Network, RETICS (Redes Temáticas de Investigación Cooperativa en Salud), Research Institute Carlos III, Spanish Ministry of Economy and Competitiveness, Madrid, SpainSearch for more papers by this authorE. Gratacos, E. Gratacos Barcelona Centre for Maternal-Fetal and Neonatal Medicine (Hospital Clínic and Hospital Sant Joan de Déu), Institut d'Investigacions Biomèdiques August Pi I Sunyer (IDIBAPS), Centre for Biomedical Research on Rare Diseases (CIBER-ER), Hospital Clínic, Universitat de Barcelona, Barcelona, SpainSearch for more papers by this authorF. Figueras, F. Figueras Barcelona Centre for Maternal-Fetal and Neonatal Medicine (Hospital Clínic and Hospital Sant Joan de Déu), Institut d'Investigacions Biomèdiques August Pi I Sunyer (IDIBAPS), Centre for Biomedical Research on Rare Diseases (CIBER-ER), Hospital Clínic, Universitat de Barcelona, Barcelona, SpainSearch for more papers by this author E. Meler, Corresponding Author E. Meler [email protected] orcid.org/0000-0002-5975-9834 Barcelona Centre for Maternal-Fetal and Neonatal Medicine (Hospital Clínic and Hospital Sant Joan de Déu), Institut d'Investigacions Biomèdiques August Pi I Sunyer (IDIBAPS), Centre for Biomedical Research on Rare Diseases (CIBER-ER), Hospital Clínic, Universitat de Barcelona, Barcelona, Spain Correspondence E. Meler, Barcelona Centre for Maternal-Fetal and Neonatal Medicine (Hospital Clínic and Hospital Sant Joan de Déu), Institut d'Investigacions Biomèdiques August Pi I Sunyer (IDIBAPS), Universitat de Barcelona, Centre for Biomedical Research on Rare Diseases (CIBER-ER), Hospital Clínic, Carrer Sabino de Arana 1, 08028 Barcelona, Spain. Email: [email protected]Search for more papers by this authorE. Mazarico, E. Mazarico Barcelona Centre for Maternal-Fetal and Neonatal Medicine (Hospital Clínic and Hospital Sant Joan de Déu), Institut de Recerca Sant Joan de Déu (IR-SJD), Barcelona, Spain Maternal and Child Health Development Network, RETICS (Redes Temáticas de Investigación Cooperativa en Salud), Research Institute Carlos III, Spanish Ministry of Economy and Competitiveness, Madrid, SpainSearch for more papers by this authorA. Peguero, A. Peguero Barcelona Centre for Maternal-Fetal and Neonatal Medicine (Hospital Clínic and Hospital Sant Joan de Déu), Institut d'Investigacions Biomèdiques August Pi I Sunyer (IDIBAPS), Centre for Biomedical Research on Rare Diseases (CIBER-ER), Hospital Clínic, Universitat de Barcelona, Barcelona, SpainSearch for more papers by this authorA. Gonzalez, A. Gonzalez Barcelona Centre for Maternal-Fetal and Neonatal Medicine (Hospital Clínic and Hospital Sant Joan de Déu), Institut de Recerca Sant Joan de Déu (IR-SJD), Barcelona, Spain Maternal and Child Health Development Network, RETICS (Redes Temáticas de Investigación Cooperativa en Salud), Research Institute Carlos III, Spanish Ministry of Economy and Competitiveness, Madrid, SpainSearch for more papers by this authorJ. Martinez, J. Martinez orcid.org/0000-0001-9837-3822 Barcelona Centre for Maternal-Fetal and Neonatal Medicine (Hospital Clínic and Hospital Sant Joan de Déu), Institut d'Investigacions Biomèdiques August Pi I Sunyer (IDIBAPS), Centre for Biomedical Research on Rare Diseases (CIBER-ER), Hospital Clínic, Universitat de Barcelona, Barcelona, SpainSearch for more papers by this authorD. Boada, D. Boada Barcelona Centre for Maternal-Fetal and Neonatal Medicine (Hospital Clínic and Hospital Sant Joan de Déu), Institut d'Investigacions Biomèdiques August Pi I Sunyer (IDIBAPS), Centre for Biomedical Research on Rare Diseases (CIBER-ER), Hospital Clínic, Universitat de Barcelona, Barcelona, SpainSearch for more papers by this authorK. Vellve, K. Vellve Barcelona Centre for Maternal-Fetal and Neonatal Medicine (Hospital Clínic and Hospital Sant Joan de Déu), Institut d'Investigacions Biomèdiques August Pi I Sunyer (IDIBAPS), Centre for Biomedical Research on Rare Diseases (CIBER-ER), Hospital Clínic, Universitat de Barcelona, Barcelona, SpainSearch for more papers by this authorG. Arca, G. Arca Department of Neonatology, Hospital Clinic, IDIBAPS, Barcelona, Spain Neonatal Group, NeNE Foundation, Barcelona, SpainSearch for more papers by this authorM. D. Gómez-Roig, M. D. Gómez-Roig Barcelona Centre for Maternal-Fetal and Neonatal Medicine (Hospital Clínic and Hospital Sant Joan de Déu), Institut de Recerca Sant Joan de Déu (IR-SJD), Barcelona, Spain Maternal and Child Health Development Network, RETICS (Redes Temáticas de Investigación Cooperativa en Salud), Research Institute Carlos III, Spanish Ministry of Economy and Competitiveness, Madrid, SpainSearch for more papers by this authorE. Gratacos, E. Gratacos Barcelona Centre for Maternal-Fetal and Neonatal Medicine (Hospital Clínic and Hospital Sant Joan de Déu), Institut d'Investigacions Biomèdiques August Pi I Sunyer (IDIBAPS), Centre for Biomedical Research on Rare Diseases (CIBER-ER), Hospital Clínic, Universitat de Barcelona, Barcelona, SpainSearch for more papers by this authorF. Figueras, F. Figueras Barcelona Centre for Maternal-Fetal and Neonatal Medicine (Hospital Clínic and Hospital Sant Joan de Déu), Institut d'Investigacions Biomèdiques August Pi I Sunyer (IDIBAPS), Centre for Biomedical Research on Rare Diseases (CIBER-ER), Hospital Clínic, Universitat de Barcelona, Barcelona, SpainSearch for more papers by this author First published: 10 March 2023 https://doi.org/10.1111/1471-0528.17422Read the full textAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL No abstract is available for this article. REFERENCES 1Li N, Ghosh G, Gudmundsson S. Uterine artery Doppler in high-risk pregnancies at 23-24 gestational weeks is of value in predicting adverse outcome of pregnancy and -selecting cases for more intense surveillance. Acta Obstet Gynecol Scand. 2014; 93(12): 1276– 81. 2Carbillon L, Benbara A, Fermaut M. A combination of clinical ultrasound Doppler and angiogenic biomarkers assessment is currently the best approach for periviable fetal-growth-restriction evaluation. BJOG. 2022. https://doi.org/10.1111/1471-0528.17352 3Meler E, Mazarico E, Peguero A, Gonzalez A, Martinez J, Boada D, et al. Death and severe morbidity in isolated periviable small-for-gestational-age fetuses. BJOG. 2022. https://doi.org/10.1111/1471-0528.17181 4Herraiz I, Quezada MS, Rodriguez-Calvo J, Gómez-Montes E, Villalaín C, Galindo A. Longitudinal change of sFlt-1/PlGF ratio in singleton pregnancy with early-onset fetal growth restriction. Ultrasound Obstet Gynecol. 2018; 52(5): 631– 8. 5Garcia-Manau P, Mendoza M, Bonacina E, Garrido-Gimenez C, Fernandez-Oliva A, Zanini J, et al. Soluble fms-like tyrosine kinase to placental growth factor ratio in different stages of early-onset fetal growth restriction and small for gestational age. Acta Obstet Gynecol Scand. 2021; 100(1): 119– 28. 6Mendoza M, Hurtado I, Bonacina E, Garcia-Manau P, Serrano B, Tur H, et al. Individual risk assessment for prenatal counseling in early-onset growth-restricted and small-for-gestational-age fetuses. Acta Obstet Gynecol Scand. 2021; 100(3): 504– 12. Volume130, Issue6May 2023Pages 688-689 ReferencesRelatedInformation

ABSTRACT Objective To report our 10‐year experience of protocol‐based management of small‐for‐gestational‐age (SGA) fetuses, based on standardized clinical and Doppler criteria, in late‐pregnancy cases. Methods A retrospective cohort was constructed of consecutive singleton pregnancies referred for late‐onset (> 32 weeks) SGA (defined as estimated fetal weight (EFW) < 10 th centile) that were classified as fetal growth restriction (FGR) or low‐risk SGA, based on the severity of smallness (EFW < 3 rd centile) and the presence of Doppler abnormalities (uterine artery pulsatility index (UtA‐PI) ≥ 95 th centile or cerebroplacental ratio (CPR) < 5 th centile). Low‐risk SGA pregnancies were followed at 2‐week intervals and delivered electively at 40 weeks. FGR pregnancies were followed at 1‐week intervals, or more frequently if there were signs of fetal deterioration, and were delivered electively after 37 + 0 weeks' gestation. The occurrence of stillbirth and composite adverse outcome (CAO; defined as neonatal death, metabolic acidosis, need for endotracheal intubation or need for admission to the neonatal intensive care unit) was analyzed in low‐risk SGA and FGR pregnancies. Results A total of 1197 pregnancies with EFW < 10 th centile were identified and classified at diagnosis as low‐risk SGA ( n = 619; 51.7%) or FGR ( n = 578; 48.3%). Of these, 160 were delivered before 37 weeks' gestation; for obstetric reasons in 93 (58.1%) cases, severe pre‐eclampsia in 33 (20.6%), FGR with severe hypoxia in 47 (29.4%) and stillbirth in four (2.5%) (indications are non‐exclusive). During follow‐up, 52/574 (9.1%) low‐risk SGA pregnancies were reclassified as FGR, whereas 22/463 (4.8%) FGR pregnancies were reclassified as low‐risk SGA. Overall, there were no stillbirths in the low‐risk SGA group and four in the FGR group, all of which occurred before 37 weeks. There were no instances of neonatal death in pregnancies delivered ≥ 37 weeks. The risk of CAO was higher in those meeting antenatal criteria for FGR at 37 weeks than in those classified as low‐risk SGA (32/493 (6.5%) vs 15/544 (2.8%); odds ratio, 2.5 (95% CI, 1.3–4.6)). In FGR pregnancies, the adjusted odds ratio (95% CI) for CAO was 6.3 (1.8–21.1) in those with EFW < 3 rd centile, while it was 3.2 (1.5–6.8) and 4.2 (1.9–8.9) in those with UtA‐PI ≥ 95 th centile and CPR < 5 th centile, respectively, as compared to FGR pregnancies without each of these criteria. Conclusion Protocol‐based risk stratification with different management and monitoring schemes for late pregnancy with a suspected SGA baby, based on clinical and Doppler criteria, enables identification and tailored assessment of high‐risk FGR, while allowing expectant management with safe perinatal outcome for low‐risk SGA fetuses. Copyright © 2020 ISUOG. Published by John Wiley & Sons Ltd.

There is a paucity of data on COVID-19 in pregnancy. The proposed study is designed to provide critical data on the characteristics of the infection in pregnant women by means of a population-based in pregnant and non-pregnant women. The primary objectives are to describe the seroprevalence, clinical spectrum compared with non-pregnant women and perinatal outcomes of COVID-19 in pregnancy. A secondary objective is to evaluate the clinical presentation of COVID-19 with maternal gut microbiota patterns. The sample size was calculated assuming a 15% COVID-19 positive rate. Baseline characteristics, clinical symptoms for COVID-19, obstetrical and perinatal outcome will be collected. In all women, nasopharyngeal (NP) swabs will be obtained for SARS-CoV2 RT-PCR and serum (maternal peripheral blood and cord blood) for SARS-CoV2 IgM and IgG. Neonatal NP swabs and antibodies in cord blood will be evaluated in all SARS-CoV2+ and 1-to-1 matched controls. Rectal swabs in pregnant women SARS-CoV2+ and controls matched 1-to-1 will be used to study the microbiota in relation with clinical presentation. Final results will be available by the end of June 2020. This study will provide important population-based data on the clinical presentation and impact on perinatal outcomes of COVID-19.

Objective To report our 10-year experience of protocol-based management of FGR, defined by standardized clinical and Doppler criteria, in late pregnancy cases. Methods A retrospective cohort was constructed of consecutive singleton pregnancies referred for late (\u003e32 weeks) small-for-gestational age (SGA) [estimated fetal weight Results A total of 1197 pregnancies with EFW p95 and CPR centile Conclusion Our 10-y experience supports that a protocol-based risk stratification with different management and monitoring schemes for late-pregnancy SGA suspected babies allows identification and tailored assessment of high-risk FGR while allowing expectant management with safe perinatal outcomes in low-risk SGA fetuses. This article is protected by copyright. All rights reserved.

Background: In the last decade NSM has emerged as a new and secure type of mastectomy in the therapeutic setting, including both primary and post-neoadjuvant therapy.

Objective: The aim of this study was to evaluate the oncological outcomes of vaginal fertility-sparing surgery plus laparoscopic sentinel lymph node biopsy in patients with early cervical cancer over a 15 years period. Patients and methods: From March 2005 to April 2018, 38 patients diagnosed with early stage cervical cancer underwent vaginal fertility-sparing surgery at the Hospital Clinic, Barcelona, Spain. Patients with FIGO stage IA1 with lymphovascular space invasion and stage IA2 underwent simple trachelectomy and patients with stage IB1 underwent radical vaginal trachelectomy. All cases underwent laparoscopic sentinel lymph node biopsy. In the first 19 cases, laparoscopic bilateral pelvic lymphadenectomy was completed immediately after sentinel lymph node biopsy. Clinical and oncological follow-up data were collected. Results: The median age at diagnosis was 33.5 years (range 22-44). Simple trachelectomy was performed in seven cases (18.4%) and vaginal radical trachelectomy in 31 (81.6%). Nineteen patients were exclusively treated with laparoscopic sentinel lymph node biopsy and 19 with sentinel lymph node biopsy plus laparoscopic bilateral pelvic lymphadenectomy. There were no significant differences between the two lymph node assessment groups regarding histology and tumour size. The median follow-up was 73 months (range 1-160 months). There were 4 recurrences (3 patients with IB1 and 1 with IA2). Two occurred in the sentinel lymph node biopsy group and 2 in the sentinel lymph node biopsy plus laparoscopic bilateral pelvic lymphadenectomy group. All the recurrences were diagnosed in patients with adenocarcinoma and in 3 patients without lymphovascular space invasion. Conclusion: Vaginal fertility-sparing surgery combined with laparoscopic sentinel lymph node biopsy seems to be a safe oncological procedure in selected patients with early stage cervical cancer. Further studies are needed to clarify the role of sentinel lymph node biopsy in fertilitysparing surgery in cervical cancer. Adenocarcinoma histology seems to be an important risk factor for recurrence. (C) 2020 Elsevier B.V. All rights reserved.

Introduction/Background The aim of this study was to analyze the oncological outcomes and risk factors for recurrence of vaginal fertility-sparing surgery (FSS) and laparoscopic sentinel lymph node biopsy (SLNB) in patients with early cervical cancer (CC). Methodology From March 2005 to April 2018, 38 patients diagnosed with early stage CC underwent vaginal FFS at the Hospital Clínic, Barcelona, Spain. Patients with FIGO stage IA1 with lymphovascular space invasion (LVSI) and stage IA2 underwent simple trachelectomy and patients with stage IB1 underwent vaginal radical trachelectomy (VRT). All cases underwent laparoscopic SLNB. In the first cases, laparoscopic bilateral pelvic lymphadenectomy (LBPL) was completed immediately after SLNB. Clinical and oncological follow-up data were prospective collected. Results The median age at diagnosis was 33.5 years old (range 22–44). Simple trachelectomy was performed in seven cases (18.4%) and VRT in 31 (81.6%). Nineteen patients were treated with laparoscopic SLNB exclusively and 19 with SLNB plus LBPL. There were no significant differences between the two groups regarding histology and tumor size. The median follow-up was 73 months (range 1–160 months). There were 4 recurrences (3 patients with IB1 and one in IA2). Two occurred in the SLNB group and 2 in the SLNB plus LBPL group. All recurrences were diagnosed in patients with adenocarcinoma tumors and three without LVSI. Conclusion Vaginal FFS with laparoscopic SLNB seems to be a safe oncological procedure in early stage CC patients. Further studies are needed to clarify the role of adenocarcinoma histology as a prognostic factor of recurrence. Disclosure Nothing to disclose.