Chemotherapy during pregnancy

Cancer during pregnancy is uncommon, although not rare. As women in developed societies defer childbearing and the incidence of most malignancies rises with increasing age, the situation in which cancer complicates pregnancy is expected to become more common. Cancer staging and treatment can be performed during pregnancy and should be defined in a multidisciplinary setting. Here, we describe the potential to use chemotherapy during pregnancy.

New insights add to the practice of administering chemotherapy from 14 weeks gestational age onwards. The placental barrier function protects the fetus. The physiologic gestational changes reduce the maternal serum levels of chemotherapy, although the pharmacodynamic impact remains unknown. Comedication to chemotherapy can be administered on strict indications. Chemotherapy after 35 weeks is not recommended as an interval of at least 3 weeks is preferred between chemotherapy administration and delivery. Recent data show that the long-term outcome of children antenatally exposed to chemotherapy is comparable to children of the same age. Nevertheless, a higher rate of neurodevelopmental problems was encountered after preterm birth, also in this selected patient population.

Administration of chemotherapy during pregnancy may decrease the need for early delivery, and thus prematurity.