Key content Cervical cancer continues to affect many women in the UK with over half under the age of 45 years at the time of diagnosis; with a trend towards starting families later in life this raises fertility concerns., While the standard treatment for stage IA2 or IB1 cervical cancer is a radical hysterectomy, radical trachelectomy has been shown to have equivalent 5-year survival and is a surgical option if there is a wish to preserve fertility., Although trachelectomies are performed by gynaecological oncologists, the management of any subsequent pregnancies falls under the remit of obstetricians who therefore require a sound knowledge of the procedure and potential obstetric sequelae., Pregnancies following trachelectomy are high risk because of the increased rate of mid-trimester miscarriage and preterm delivery, often as a consequence of preterm prelabour rupture of membranes., Delivery is by caesarean section, traditionally by classical section as a permanent isthmic suture is placed at the time of trachelectomy, but nowadays a transverse incision may be used to reduce morbidity and the implications on future fertility., Learning objectives Management of a pregnancy following radical trachelectomy., Intrapartum care of post-radical trachelectomy pregnancy and complication risks., Impact of trachelectomy and subsequent pregnancy on the woman., Ethical issues Informed consent surrounding trachelectomy and future pregnancies. [ABSTRACT FROM AUTHOR]