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Chapter 28 - Cancer

from Section 4 - The pregnant patient with coexisting disease

Published online by Cambridge University Press:  05 July 2013

By
Kristel Van Calsteren  and
Frederic Amant
Edited by
Marc van de Velde ,
Helen Scholefield  and
Lauren A. Plante
Marc van de Velde
Affiliation:
University Hospital Leuven
Helen Scholefield
Affiliation:
Liverpool Women's Hospital
Lauren A. Plante
Affiliation:
Drexel University College of Medicine
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Summary

The diagnosis and treatment of cancer in pregnant women is a clinical and ethical challenge for medical care workers. The complex medical, ethical, psychological, and religious issues arising in pregnant women with cancer demand care from a multidisciplinary team with obstetricians, oncologists, radiation oncologists, surgeons, pediatricians, geneticists, and psychologists. Surgery can be performed safely during pregnancy. The placenta seems to fulfill its barrier role for most of the chemotherapeutic drugs and reduces fetal exposure to chemotherapy. Radiation doses used in cancer therapy are in the range 30-70 Gy. Biological agents have the potential to affect the fetus and should be used with caution during pregnancy. Supportive treatment for pregnant women is possible, similar to non-pregnant women. Considering the gestational period, surgery, chemotherapy (not in the first trimester), and radiotherapy (not in the third trimester) can safely be applied in pregnancy. Hormonal therapy and trastuzumab should be deferred until after birth.

Keywords

volume-controlled continuous mandatory ventilationpositive end-expiratory pressurepregnant patientintermittent mandatory ventilationmechanical ventilationnon-invasive ventilationpressure-controlled continuous mandatory ventilationcontinuous mandatory ventilationacute respiratory distress syndromeairway pressure release ventilation
Type
Chapter
Information
Maternal Critical Care
A Multidisciplinary Approach
 , pp. 313 - 321
Publisher: Cambridge University Press
Print publication year: 2013

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