Navigating a Dual Challenge: Management of Advanced Ovarian Cancer Diagnosed During the Second Trimester

Ovarian cancer during pregnancy is rare, and diagnosis is often delayed as symptoms overlap with normal pregnancy and tumour markers are unreliable. We present a case of a 31-year-old patient who presented at 21 weeks' gestation with bilateral pleural effusions and respiratory compromise. Pleural cytology confirmed metastatic carcinoma consistent with a gynaecologic primary. After multidisciplinary review, neoadjuvant chemotherapy with carboplatin and paclitaxel was initiated in the second trimester and continued into the third trimester. Foetal surveillance revealed appropriate growth with no adverse effects. Labour was induced at 37 weeks, resulting in vaginal delivery of a healthy infant. The patient subsequently underwent interval cytoreductive surgery three weeks postpartum, followed by adjuvant chemotherapy, and remains in remission. This case demonstrates that platinum-taxane chemotherapy can be safely administered in pregnancy with favourable maternal and neonatal outcomes.