Clinical analysis of 14 pregnant women with malignancy

doi:10.3877/cma.j.issn.2095-3259.2016.04.013

Abstract

Abstract:

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.

Key words: Pregnancy complications, neoplastic, Antineoplastic protocols, Pregnancy outcome

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

/ / Recommend

Add to citation manager EndNote|Ris|BibTeX

URL: https://zhckjjdzzz.cma-cmc.com.cn/EN/10.3877/cma.j.issn.2095-3259.2016.04.013

https://zhckjjdzzz.cma-cmc.com.cn/EN/Y2016/V05/I04/249

Figures/Tables 1

References 18

[1]	Pavlidis N. Cancer and pregnancy: what should we know about the management with systemic treatment of pregnant women with cancer? [J]. Eur J Cancer, 2011, 47(3):S348-S352.
[2]	Lee YY, Roberts CL, Dobbins T, et al. Incidence and outcomes of pregnancy-associated cancer in Australia, 1994－2008: a population-based linkage study [J]. BJOG, 2012, 119(13):1572-1582.
[3]	Pavlidis NA. Coexistence of pregnancy and malignancy [J]. Oncologist, 2002, 7(4):279-287.
[4]	Stensheim H, Møller B, van Dijk T, et al. Cause-specific survival for women diagnosed with cancer during pregnancy or lactation: a registry-based cohort study [J]. J Clin Oncol, 2009, 27(1):45-51.
[5]	Lee YY, Roberts CL, Young J, et al. Using hospital discharge data to identify incident pregnancy-associated cancers: a validation study [J]. BMC Pregnancy and Childbirth, 2013, 13(1):37.
[6]	Plante M, Renaud MC, Francois H, et al. Vaginal radical trachelectomy: an on cologically safe ferility-preserving surgery. An updated series of 72 cases and review of literature[J]. Gynecol Oncol, 2004, 94(3):614-623.
[7]	Kizer NT, Powell MA. Surgery in the pregnant patient [J]. Clin Obstet Gynecol, 2011, 54(4):633-641.
[8]	Cardonick E, Dougherty R, Grana G, et al. Breast cancer during pregnancy: Maternal and fetal outcomes [J]. Cancer J, 2010, 16(1):76-82.
[9]	Mazonakis M, Varveris H, Damilakis J, et al. Radiation dose to conceptus resulting from tangential breast irradiation [J]. Int J Radiat Oncol Biol Phys, 2003, 55(2):386-391.
[10]	Doll DC, Ringenberg QS, Yarbro JW. Antineoplastic agents and pregnancy [J]. Semin Oncol, 1989, 16:337-346.
[11]	Mir O, Berveiller P, Rouzier R, et al. Chemotherapy for breast cancer during pregnancy: Is epirubicin safe? [J]. Ann Oncol, 2008, 19(10):1814-1815.
[12]	Zagouri F, Sergentanis TN, Chrysikos D, et al. Platinum derivatives during pregnancy in cervical cancer: a systematic review and meta-analysis [J]. Obstet Gynecol, 2013, 121(2):337-343.
[13]	Amant F, Loibl S, Neven P, et al. Breast cancer in pregnancy [J]. Lancet, 2012, 379(9815):570-579.
[14]	Cai WB, Zhang Y, Cheng R, et al. Dual inhibition of plasminogen kringle 5 on angiogenesis and chemotaxis suppresses tumor metastasis by targeting HIF-1a pathway [J]. PLoS One, 2012, 7(12):e53152.
[15]	Zoccarato G, Romagnolo C, Ghiotto C, et al. High frequency of premature births in concomitant pregnancy and cancer [J]. J Clin Oncol, 2010, 28:e12020.
[16]	Fruscio R, Villa A, Chiari S, et al. Delivery delay with neoadjuvant chemotherapy for cervical cancer patients during pregnancy: a series of nine cases and literature review [J]. Gynecol Oncol, 2012, 126(2):192-197.
[17]	Ali SA, Gupta S, Sehgal R, et al. Survival outcomes in pregnancy associated breast cancer: a retrospective case control study [J]. Breast J, 2012, 18(2):139-144.
[18]	Tretli S, Kvalheim G, Thoresen S, et al. Survival of breast cancer patients diagnosed during pregnancy or lactation [J]. Br J Cancer, 1988, 58:382-384.

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^＋周	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^＋周	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^＋周	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^＋周	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^＋周	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^＋周	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^＋周	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^＋周	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^＋周	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^＋周	期待治疗	－	无	孕22周死亡	不存活

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^＋周	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^＋周	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^＋周	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^＋周	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^＋周	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^＋周	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^＋周	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^＋周	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^＋周	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^＋周	期待治疗	－	无	孕22周死亡	不存活

Please choose a citation manager

Content to export