Facts, Views & Vision
in ObGyn

Abstract

Based on an estimated incidence of of 1 cancer case per 1000-1500 pregnancies, 3000-5000 new patients can be
expected in Europe annually. The treatment of cancer in pregnant women is a challenge since both the maternal and
the fetal well-being need to be considered. This study was initiated to gain more insight into the problems associated
with cancer and chemotherapy during pregnancy.

A multicentric registration study was set up to evaluate the currently applied treatment modalities for cancer during
pregnancy, and the consequences of their use for pregnancy. Secondly, a preclinical and clinical pharmacological study
addressing pharmacokinetics of chemotherapy in pregnant women and transplacental passage of chemotherapy was
performed. Thirdly, we investigated the effects of prenatal exposure to chemotherapy on fetal neurological development.
We observed an equal distribution of tumour types between pregnant and age-matched nonpregnant women. Data on
neonatal outcome suggest that exposure to chemotherapy in the 2ndor 3rdtrimester of pregnancy does not worsen out-
come. This finding is explained by the fact that chemotherapy is not administered during the period of organogenesis
and by the fetal protection offered by the placental barrier-function. Physiological changes of pregnancy resulted in a
decreased plasma drug exposure of chemotherapeutic agents.

Before major conclusions can be drawn with regard to the long term fetal outcome and the efficacy of chemotherapy
during pregnancy, more patients and a longer follow up period is required. Therefore, this research project is continued
and expanded nationally and internationally.