Department of Obstetrics and Gynecology, Jordan University of Science and Technology, Irbid, Jordan.
Int J Gynecol Cancer. 2011 Aug;21(6):1159-64. doi: 10.1097/IGC.0b013e31821e73b2.
This study aimed to assess the management and the obstetric and neonatal outcomes of pregnancies complicated by cancer.
A retrospective analysis of patients with cancer during pregnancy who were treated at King Hussein Cancer Center and King Abdullah University Hospital in Jordan between January 2002 and December 2009 was conducted. The medical records of patients with invasive cancer diagnosed during pregnancy and their newborns were reviewed to retrieve information on treatment and obstetric and neonatal outcomes. Numerical data were tested for normal distribution using Kolmogorov-Smirnov. Statistical analyses were conducted using SPSS 18.0.
A total of 46 patients with a diagnosis of cancer in pregnancy were treated. The most common tumor types were breast cancer, hematologic malignancies, and gastrointestinal malignancies. In 17 patients, a miscarriage or a termination of pregnancy occurred in the first trimester. In 25 of 46 patients, a single or a combination of treatment modalities was commenced. The distribution of therapies was as follows: chemotherapy alone, n = 5; surgery alone, n = 7; surgery and chemotherapy, n = 6; surgery and radiation therapy, n = 1; surgery with chemotherapy and radiation therapy, n = 3; chemotherapy and radiation therapy, n = 1; interferon, n = 1; and hormonal therapy, n = 1. The mean (SD) gestational age at delivery was 35.7 (2.7) weeks. The mean birth weight was 2580 (870) g. Preterm delivery occurred in 17 patients. There were 4 neonatal deaths, 2 of them delivered at 33 weeks, 1 delivered at 34 weeks, and 1 delivered at 35 weeks gestation. There were no congenital malformations.
The remarkable finding is a high rate of iatrogenic preterm delivery with a high rate of neonatal mortality. Delivery should be postponed preferably until after a gestational age of 35 weeks.
本研究旨在评估癌症合并妊娠的管理以及母婴结局。
对 2002 年 1 月至 2009 年 12 月在约旦侯赛因国王癌症中心和阿卜杜拉国王大学医院治疗的癌症合并妊娠患者进行回顾性分析。检索诊断为妊娠期间侵袭性癌症的患者及其新生儿的病历，以获取治疗和母婴结局信息。使用 Kolmogorov-Smirnov 检验数值数据是否服从正态分布。使用 SPSS 18.0 进行统计分析。
共治疗了 46 例妊娠期癌症患者。最常见的肿瘤类型是乳腺癌、血液系统恶性肿瘤和胃肠道恶性肿瘤。17 例患者在妊娠早期发生流产或终止妊娠。46 例患者中有 25 例接受了单一或联合治疗。治疗方式分布如下：单纯化疗 5 例，单纯手术 7 例，手术联合化疗 6 例，手术联合放疗 1 例，手术联合化疗和放疗 3 例，化疗联合放疗 1 例，干扰素 1 例，激素治疗 1 例。分娩时的平均（SD）孕周为 35.7（2.7）周。平均出生体重为 2580（870）g。17 例患者早产。新生儿死亡 4 例，其中 2 例 33 周分娩，1 例 34 周分娩，1 例 35 周分娩。无先天性畸形。
令人瞩目的发现是医源性早产率高，新生儿死亡率高。最好将分娩时间推迟到 35 周后。
