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Management of pregnancy in women with cancer

As the incidence of cancer in pregnancy has been increasing in recent decades, more specialists are confronted with a complex oncologic–obstetric decision-making process. With the establishment of (inter)national registries, including the International Network on Cancer, Infertility and Pregnancy, a...

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Autores principales: Wolters, Vera, Heimovaara, Joosje, Maggen, Charlotte, Cardonick, Elyce, Boere, Ingrid, Lenaerts, Liesbeth, Amant, Frédéric
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BMJ Publishing Group 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7925815/
https://www.ncbi.nlm.nih.gov/pubmed/33649001
http://dx.doi.org/10.1136/ijgc-2020-001776
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author Wolters, Vera
Heimovaara, Joosje
Maggen, Charlotte
Cardonick, Elyce
Boere, Ingrid
Lenaerts, Liesbeth
Amant, Frédéric
author_facet Wolters, Vera
Heimovaara, Joosje
Maggen, Charlotte
Cardonick, Elyce
Boere, Ingrid
Lenaerts, Liesbeth
Amant, Frédéric
author_sort Wolters, Vera
collection PubMed
description As the incidence of cancer in pregnancy has been increasing in recent decades, more specialists are confronted with a complex oncologic–obstetric decision-making process. With the establishment of (inter)national registries, including the International Network on Cancer, Infertility and Pregnancy, and an increasing number of smaller cohort studies, more evidence on the management of cancer during pregnancy is available. As fetal, neonatal, and short-term pediatric outcomes after cancer treatment are reassuring, more women receive treatment during pregnancy. Prenatal treatment should adhere to standard treatment as much as possible to optimize maternal prognosis, always taking into account fetal well-being. In order to guarantee the optimal treatment for both mother and child, a multidisciplinary team of specialists with expertise should be involved. Apart from oncologic treatment, a well-considered obstetric and perinatal management plan discussed with the future parents is crucial. Results of non-invasive prenatal testing are inconclusive in women with cancer and alternatives for prenatal anomaly screening should be used. Especially in women treated with chemotherapy, serial ultrasounds are strongly recommended to follow-up fetal growth and cervical length. After birth, a neonatal assessment allows the identification of any cancer or treatment-related adverse events. In addition, placental histologic examination aims to assess the fetal risk of metastasis, especially in women with malignant melanoma or metastatic disease. Breastfeeding is discouraged when systemic treatment needs to be continued after birth. At least a 3-week interval between the last treatment and nursing is recommended to prevent any treatment-induced neonatal effects from most non-platinum chemotherapeutic agents.
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spelling pubmed-79258152021-03-19 Management of pregnancy in women with cancer Wolters, Vera Heimovaara, Joosje Maggen, Charlotte Cardonick, Elyce Boere, Ingrid Lenaerts, Liesbeth Amant, Frédéric Int J Gynecol Cancer Review As the incidence of cancer in pregnancy has been increasing in recent decades, more specialists are confronted with a complex oncologic–obstetric decision-making process. With the establishment of (inter)national registries, including the International Network on Cancer, Infertility and Pregnancy, and an increasing number of smaller cohort studies, more evidence on the management of cancer during pregnancy is available. As fetal, neonatal, and short-term pediatric outcomes after cancer treatment are reassuring, more women receive treatment during pregnancy. Prenatal treatment should adhere to standard treatment as much as possible to optimize maternal prognosis, always taking into account fetal well-being. In order to guarantee the optimal treatment for both mother and child, a multidisciplinary team of specialists with expertise should be involved. Apart from oncologic treatment, a well-considered obstetric and perinatal management plan discussed with the future parents is crucial. Results of non-invasive prenatal testing are inconclusive in women with cancer and alternatives for prenatal anomaly screening should be used. Especially in women treated with chemotherapy, serial ultrasounds are strongly recommended to follow-up fetal growth and cervical length. After birth, a neonatal assessment allows the identification of any cancer or treatment-related adverse events. In addition, placental histologic examination aims to assess the fetal risk of metastasis, especially in women with malignant melanoma or metastatic disease. Breastfeeding is discouraged when systemic treatment needs to be continued after birth. At least a 3-week interval between the last treatment and nursing is recommended to prevent any treatment-induced neonatal effects from most non-platinum chemotherapeutic agents. BMJ Publishing Group 2021-03 2021-02-25 /pmc/articles/PMC7925815/ /pubmed/33649001 http://dx.doi.org/10.1136/ijgc-2020-001776 Text en © IGCS and ESGO 2021. Re-use permitted under CC BY. Published by BMJ. https://creativecommons.org/licenses/by/4.0/ https://creativecommons.org/licenses/by/4.0/This is an open access article distributed in accordance with the Creative Commons Attribution 4.0 Unported (CC BY 4.0) license, which permits others to copy, redistribute, remix, transform and build upon this work for any purpose, provided the original work is properly cited, a link to the licence is given, and indication of whether changes were made. See: https://creativecommons.org/licenses/by/4.0/.
spellingShingle Review
Wolters, Vera
Heimovaara, Joosje
Maggen, Charlotte
Cardonick, Elyce
Boere, Ingrid
Lenaerts, Liesbeth
Amant, Frédéric
Management of pregnancy in women with cancer
title Management of pregnancy in women with cancer
title_full Management of pregnancy in women with cancer
title_fullStr Management of pregnancy in women with cancer
title_full_unstemmed Management of pregnancy in women with cancer
title_short Management of pregnancy in women with cancer
title_sort management of pregnancy in women with cancer
topic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7925815/
https://www.ncbi.nlm.nih.gov/pubmed/33649001
http://dx.doi.org/10.1136/ijgc-2020-001776
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