DOI: http://dx.doi.org/10.18203/2320-1770.ijrcog20200883

Pregnancy outcomes in non-gynecological and non-hematological cancers: a retrospective cohort

Minakshi Kumari, Hilda Yenuberi, Swati Rathore, Deepak Abraham, V. T. K. Titus, Jiji Elizabeth Mathews, Ashish Singh

Abstract


Background: Of all the cancers in women, about 10% manifest in the reproductive age group. These can be broadly classified as gynaecological cancers and non-gynaecological cancers; Among the non-gynaecological cancers besides haematological cancer, breast, thyroid, colon, bone and CNS are seen rarely. Clinical acumen in diagnosis and management of these rare cancers that appear during pregnancy or before pregnancy are difficult due to insufficient guidelines and rarity of the conditions.

Methods: A retrospective analysis of rare cancers during a period of 10 years in this hospital was performed. Data concerning the gestational age at delivery, birth weight, mode of delivery and complications and the management of the cancers during the pregnancy were collected.

Results: Among the 41 women with these rare non-gynecological, non-hematological cancers, 13 pregnancies were in women with prior history of cancers and 28 pregnancies were with current history of cancer. Majority of these cases with prior history were thyroid cancers who had uneventful pregnancies and delivered normally. Among pregnancies with current history of cancer, breast, CNS, GIT, and head and neck were the cancers with 5-6 cancers in each category. About 50% of these cancers were delivered early between 31-35 weeks to facilitate optimal treatment. Cancers with guarded prognosis diagnosed before 20 weeks had a termination of pregnancy.

Conclusions: Cancers during pregnancies are rare and their care must be individualized.


Keywords


Breast, Cancer, Central nervous system, Pregnancy, Thyroid

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References


Worldwide cancer data. World Cancer Research Fund, 2018. Available at: https://www.wcrf.org/dietandcancer/cancer-trends/worldwide-cancer-data. Accessed on 10th December 2019.

Coccia PF. Overview of adolescent and young adult oncology. J Oncol Pract. 2019:235-7.

Botha MH, Rajaram S, Karunaratne K. Cancer in pregnancy. Int J Gynecol Obstet. 2018;143(S2):137-42.

Pavlidis NA. Coexistence of pregnancy and malignancy. The Oncol. 2002;7(4):279-87.

Timur H, Tokmak A, Iskender c, Yildiz ES, Inal HA, Uygur D, et al. Obstetric outcomes in non-gynecologic cancer patients in remission. Eurasian J Med. 2016;48(2):130-4.

Anderson C, Engel SM, Anders CK, Nichols HB. Live birth outcomes after adolescent and young adult breast cancer. Int J Cancer. 2018;142(10):1994-2002.

Durrani S, Akbar S, Heena H. Breast cancer during pregnancy. Cureus. 2018;10(7):e2941.

Terry AR, Barker FG, Leffert L, Bateman BT, Souter I, Plotkin SR. Outcomes of hospitalization in pregnant women with CNS neoplasms: a population-based study. Neuro-Oncol. 2012;14(6):768-76.

Kumar N, Kumar R, Kapoor R, Ghoshal S, Kumar P, Salunke PS, et al. Intracranial meningeal hemangiopericytoma: 10 years-experience of a tertiary care Institute. Acta Neurochir (Wien). 2012;154(9):1647-51.

Postl LK, Gradl G, von Eisenhart-Rothe R, Toepfer A, Pohlig F, Burgkart R, et al. Management of musculoskeletal tumors during pregnancy: a retrospective study. BMC Womens Health. 2015;15(1):48.

Fiueiro-Filho EA, Al-Sum H, Parrish J, Wunder JS, Maxwell C. Maternal and fetal outcomes in pregnancies affected by bone and soft tissue tumors. AJP Rep. 2018;8(4):e343-8.

Cardonick EH, Gringlas MB, Hunter K, Greenspan J. Development of children born to mothers with cancer during pregnancy: comparing in utero chemotherapy-exposed children with nonexposed controls. Am J Obstet Gynecol. 2015;212(5):658-e1.