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中华产科急救电子杂志 ›› 2016, Vol. 05 ›› Issue (04) : 249 -253. doi: 10.3877/cma.j.issn.2095-3259.2016.04.013

所属专题: 经典病例 文献

论著

妊娠合并恶性肿瘤14例临床分析
周燕媚1, 陈敦金1,()   
  1. 1. 510150 广州医科大学附属第三医院妇产科 广州重症孕产妇救治中心
  • 收稿日期:2016-05-05 出版日期:2016-11-18
  • 通信作者: 陈敦金
  • 基金资助:
    广州市教育局协同创新重大项目(13xt04); 广州市科技惠民专项项目(2014Y2-00182); 产科重大疾病防控创新团队(2015KCXTD020)

Clinical analysis of 14 pregnant women with malignancy

Yanmei Zhou1, Dunjin Chen1,()   

  1. 1. Department of Obstetrics and Gynecology, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou 510150, China
  • Received:2016-05-05 Published:2016-11-18
  • Corresponding author: Dunjin Chen
  • About author:
    Corresponding author: Chen Dunjin, Email:
引用本文:

周燕媚, 陈敦金. 妊娠合并恶性肿瘤14例临床分析[J/OL]. 中华产科急救电子杂志, 2016, 05(04): 249-253.

Yanmei Zhou, Dunjin Chen. Clinical analysis of 14 pregnant women with malignancy[J/OL]. Chinese Journal of Obstetric Emergency(Electronic Edition), 2016, 05(04): 249-253.

目的

探讨妊娠合并恶性肿瘤患者的临床特点及母儿结局。

方法

收集2009年10月至2015年12月就诊于广州医科大学附属第三医院妇产科的14例妊娠合并恶性肿瘤患者的临床资料,对患者的临床特点、孕期治疗、妊娠结局及预后进行分析。

结果

14例妊娠合并恶性肿瘤患者的肿瘤类型分别为血液系统恶性肿瘤(8例)、乳腺癌(4例)和宫颈癌(2例)。足月分娩者有5例,早产6例,1例早期人工流产,1例中孕期引产,1例孕期死亡。共分娩新生儿11例,2例乳腺癌患者于孕期接受抗癌治疗,2例新生儿为足月儿;10例患者孕期选择期待治疗,9例患者的新生儿存活,包括3例足月儿和6例早产儿。

结论

妊娠合并恶性肿瘤可导致严重的不良妊娠结局,根据病情孕期应进行合理的抗癌治疗可改善患者结局。

Objective

To investigate the clinical characteristics and the maternal-fetal outcome of pregnancy with malignancy.

Methods

A retrospective study was conducted in 14 pregnant women with malignancy. The patients were admitted to the The Third Affiliated Hospital of Guangzhou Medical University from September 2009 to December 2015. Clinical characteristics, treatment during pregnancy, pregnancy outcome and prognosis of the patients were analyzed.

Results

Among the 14 cases, 8 patients were hematologic malignancies, 4 patients were breast cancer and 2 patients were cervical cancer. As a result, 5 cases were full-term neonates, 6 cases exposed preterm birth, 1 patient performed induced abortion during the first trimester of pregnancy, 1 patient underwent labor induction during the second trimester of pregnancy, and 1patient died during pregnancy. There were 11 newborns. Two breast cancer patients received anticancer treatment, and they delivered babies at term. Ten patients chose expectant management during pregnancy and 9 neonates were born, including 3 full-term neonates and 6 preterm birth.

Conclusion

Pregnant women with malignancy can result in serious adverse pregnancy outcomes. The outcomes can be improved if reasonable anticancer treatment were performed according to the gestation.

表1 14例妊娠合并恶性肿瘤患者的临床特点、孕期治疗和结局
例序 年龄(岁) 恶性肿瘤类型及病情 诊断时间 抗癌治疗方案 分娩方式 妊娠结局 患者结局 新生儿结局
1 30 乳癌根治术及化疗后复发并感染 孕31周诊断癌症复发 产后治疗 剖宫产 早产 存活 低出生体重儿,新生儿黄疸
2 27 右乳腺癌根治术及化疗后复发并远处转移 孕16周诊断癌症复发 产后治疗 顺产 早产 存活 低出生体重儿,新生儿黄疸,心肌损害
3 31 左乳腺癌 12 于孕20周行手术治疗和化疗 剖宫产 足月分娩 存活 先心病:卵圆孔未闭,新生儿黄疸,心肌损害
4 32 左侧乳腺浸润癌 28 于孕28周行左乳腺癌切除术 剖宫产 足月分娩 存活 存活,未发现新生儿并发症
5 31 宫颈癌 31 产后治疗 剖宫产 足月分娩 存活 存活,未发现新生儿并发症
6 27 宫颈癌 产后1个月 产后治疗 剖宫产 早产 存活 新生儿感染,黄疸,动脉导管未闭,胃肠功能紊乱,贫血
7 29 急性白血病 33 产后治疗 剖宫产 早产 存活 心肌损害,黄疸
8 26 急性白血病 28 产后治疗 剖宫产 早产 存活 新生儿呼吸窘迫综合征,感染,心肌损害,混合性酸中毒,贫血,黄疸
9 25 急性白血病 31 产后治疗 剖宫产 早产 产后1年内死亡 新生儿呼吸窘迫综合征,暂时性凝血功能障碍,寒冷损伤综合征,黄疸
10 31 慢性白血病 28 产后治疗 顺产 足月分娩 存活 存活,未发现新生儿并发症
11 34 慢性白血病 38 产后治疗 剖宫产 足月分娩 存活 存活,未发现新生儿并发症
12 28 急性白血病 8 化疗 人工流产 存活 不存活
13 29 急性白血病 18周 化疗 引产 存活 不存活
14 35 急性白血病 14 期待治疗 孕22周死亡 不存活
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