Article Text
Abstract
Introduction/Background Cancer complicates approximately 0.1% of all pregnancies. The management represent a challenge because the need of balancing the risks for mother and baby. This study reports our experience in oncological and obstetrical care in patients with cancer in pregnancy (CIP).
Methodology Retrospective cohort study including 78 women with primary invasive CIP between 2006 and 2022 observed in our Institution; oncologic, obstetric and neonatal data were collected from 64 cases,14 excluded for incomplete data.
Results The most common cancer was breast cancer (84.7%). Most of the cancer were diagnosed at an early stage, except for a case of IV stage lung cancer and a case of III stage ovarian cancer. Patients characteristics are shown in table 1. After multidisciplinary consultancy, patients were encouraged to continue the pregnancy and to receive a cancer treatment. Pregnancy management included standard prenatal care, ultrasound assessment of fetal growth in the third trimester and assessment of fetal wellbeing after chemotherapy administration. The mean gestational age at delivery was 36 weeks. Delivery was elective in 79% of cases, mainly due to the need to continue oncologic therapy. Mode of delivery was c-section in 56.2% and vaginal birth in 43.8%. Placental tissue was collected for histological analysis.
All the babies were born alive, and only three required intensive care because of IUGR (Intrauterine Growth Restriction). No maternal, fetal or neonatal deaths were observed.
Conclusion CIP is a rare but progressively increasing event. A multidisciplinary team including oncologists, obstetricians and pediatricians is crucial to balance the oncologic treatment with pregnancy management in order to avoid major neonatal complication due to iatrogenic prematurity beyond treatment’s side effects as well as safeguarding the patient therapeutic indication.