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孕期化疗

Chemotherapy in pregnancy.

作者信息

Ngu Siew-Fei, Ngan Hextan Y S

机构信息

Department of Obstetrics and Gynaecology, The University of Hong Kong, Queen Mary Hospital, Hong Kong.

出版信息

Best Pract Res Clin Obstet Gynaecol. 2016 May;33:86-101. doi: 10.1016/j.bpobgyn.2015.10.007. Epub 2015 Oct 19.

Abstract

Cancer diagnosed during pregnancy is uncommon, complicating between 0.02% and 0.1% of all pregnancies. Nonetheless, due to increasing age of childbearing, the incidence of cancer during pregnancy is likely to increase due to higher incidence of several age-dependent malignancies. The most common malignancies include breast cancer, cervical cancer, malignant melanoma and lymphoma. One of the key challenges in the management of cancer in pregnancy is treating the women with standard chemotherapy regimen, without compromising the safety of the developing foetus. Exposure of chemotherapy in the first trimester is associated with an increased risk of major birth defects, whereas use in the second and third trimesters is associated with intrauterine growth restriction, low birthweight and stillbirth. In this article, we review available data regarding the use of chemotherapeutic agents in pregnancy, and we summarise the neonatal outcomes, including malformations, perinatal complications and long-term follow-up. In addition, the management plan during pregnancy is also discussed.

摘要

孕期诊断出癌症并不常见,在所有妊娠中占比0.02%至0.1%。尽管如此,由于生育年龄的增加,孕期癌症的发病率可能会因几种与年龄相关的恶性肿瘤发病率上升而增加。最常见的恶性肿瘤包括乳腺癌、宫颈癌、恶性黑色素瘤和淋巴瘤。孕期癌症管理的关键挑战之一是使用标准化疗方案治疗女性,同时不损害发育中胎儿的安全。孕早期接触化疗与重大出生缺陷风险增加有关,而在孕中期和孕晚期使用化疗则与宫内生长受限、低出生体重和死产有关。在本文中,我们回顾了关于孕期使用化疗药物的现有数据,并总结了新生儿结局,包括畸形、围产期并发症和长期随访情况。此外,还讨论了孕期的管理计划。

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