Dotters-Katz Sarah, McNeil Michael, Limmer Jane, Kuller Jeffrey
Resident, Obstetrics and Gynecology, Department of Obstetrics and Gynecology, Duke University Medical Center, Durham, NC.
Medical Student, Department of Obstetrics and Gynecology, Duke University Medical Center, Durham, NC.
Obstet Gynecol Surv. 2014 May;69(5):277-86. doi: 10.1097/OGX.0000000000000068.
Although uncommon, the incidence of cancer complicating pregnancy is increasing. Managing these pregnancies creates many diagnostic, therapeutic, and ethical dilemmas for the patient, her family, and the medical care team. Despite concerns for fetal well-being, maternal survival should be the first priority. Although surgery and chemotherapy may be used during pregnancy, radiation is generally contraindicated. For most nongynecologic cancers, termination of pregnancy does not improve maternal outcome. Iatrogenic prematurity is the most common pregnancy complication associated with malignancy in pregnancy because many of these infants are delivered early to facilitate maternal treatment. Overall, maternal cancer survival is generally good and does not differ from that of nonpregnant patients.
尽管并不常见,但妊娠合并癌症的发病率正在上升。处理这些妊娠问题给患者、其家人以及医疗团队带来了诸多诊断、治疗和伦理困境。尽管要关注胎儿的健康,但产妇的生存应是首要优先事项。虽然孕期可能会使用手术和化疗,但一般禁忌放疗。对于大多数非妇科癌症,终止妊娠并不能改善产妇结局。医源性早产是妊娠合并恶性肿瘤最常见的妊娠并发症,因为许多此类婴儿会提前分娩以便于产妇接受治疗。总体而言,产妇癌症的生存率通常良好,与非妊娠患者并无差异。