The incidence of cancer during pregnancy is steadily rising because of the postponement of plans for childbearing. One of the most common cancers diagnosed during pregnancy is cervical cancer. Diagnosis of most cases usually occurs in the early stages, but there are still cases of tumors staged IB2 and higher. In these cases, the treatment strategy entails administration of neoadjuvant chemotherapy. However, a universally recognized standardized regimen for neoadjuvant chemotherapy treatment of cervical cancer during pregnancy has yet to be established. The chemotherapy agents used during treatment are known for their fetal adverse effects. The aim of the therapy is to attain full-term pregnancy while minimizing fetal toxicity and decreasing tumor size. In this case report, we present a first-time sequential chemotherapy administration to minimize the cumulative toxicity of individual regimens and demonstrate the benefits for the patient and fetus.

• Publikační typ
• časopisecké články MeSH
• kazuistiky MeSH

INTRODUCTION: Chemotherapy during pregnancy can increase the risk of fetal anemia. Severe fetal anemia can lead to the development of hydrops fetalis and potentially fetal demise. Hence, it is imperative to implement consistent monitoring methods in the context of chemotherapy treatment. This study aimed to diagnose and monitor fetal anemia using middle cerebral artery peak systolic velocity (MCA-PSV) as a diagnostic tool during chemotherapy in pregnant women. MATERIAL AND METHODS: The study employed a prospective analysis involving a case series of 15 patients diagnosed with cancer during pregnancy and subsequently underwent chemotherapy. MCA-PSV was used to identify fetal anemia. The patients were scheduled for ultrasound examinations of the MCA-PSV. The first examination was performed on the same day as the administration of chemotherapy, while the second occurred on the 10th day after chemotherapy. The measurement technique used in the study was based on the methodology proposed by Mari and Barr. The multiples of the median were calculated using the calculators provided by Medicina Fetal Barcelona. Based on these values anemia severity was determined. When moderate or severe anemia was identified, chemotherapy was individually modified. Additionally, a blood count analysis was conducted immediately after the delivery of the newborn. RESULTS: Five patients were diagnosed with fetal or newborn anemia. With MCA-PSV, we identified moderate fetal anemia in two patients and severe fetal anemia in one. The complete blood count testing of newborns revealed mild anemia in three patients. One case was unrelated to chemotherapy-induced anemia. During treatment, fetal anemia did not corelate with maternal anemia. CONCLUSIONS: In four cases of anemia the combination of cisplatin and iphosphamide was used as a chemotherapy agent. No anemia was observed in other drug combinations. Our findings suggest that MCA-PSV is a reliable method for identifying anemia and should be included in the treatment protocol for chemotherapy-induced fetal anemia.

• MeSH
• anemie * chemicky indukované   diagnóza   MeSH
• arteria cerebri media diagnostické zobrazování   MeSH
• lidé MeSH
• nemoci plodu * chemicky indukované   diagnostické zobrazování   MeSH
• novorozenec MeSH
• protinádorové látky * MeSH
• rychlost toku krve MeSH
• těhotenství MeSH
• ultrasonografie prenatální MeSH
• Check Tag
• lidé MeSH
• novorozenec MeSH
• těhotenství MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH

Mezi nejčastější nádorová onemocnění v těhotenství patří gynekologické malignity, maligní melanom, hematologické malignity a karcinom štítné žlázy. Vzhledem k tomu, že řada příznaků maligního onemocnění je maskována fyziologickými změnami těhotenství, má diagnostika těchto onemocnění svá specifika a limitace. V rámci diagnostiky a stagingu preferujeme metody, které nevyužívají ionizující záření, a proto v popředí diagnostiky stojí ultrazvukové vyšetření a magnetická rezonance. Využití nádorových markerů v těhotenství je limitováno, protože řada z nich je v těhotenství fyziologicky zvýšená. I přestože tato onemocnění patří mezi poměrně vzácná, je třeba na ně pamatovat a pacientku s podezřením na toto onemocnění odeslat na specializované pracoviště.

The most common cancer diseases in pregnancy include gynaecological malignancies, malignant melanoma, haematological malignancies, and thyroid carcinoma. Given the fact that a number of malignant disease symptoms are masked by physiological changes in pregnancy, their diagnosis has specific considerations and limitations. For diagnosis and staging, modalities that do not use ionizing radiation are preferred; therefore, ultrasound examination and magnetic resonance imaging are at the forefront of diagnosis. The use of tumour markers in pregnancy is limited since a number of them are increased physiologically during pregnancy. Although relatively rare, these diseases should be kept in mind and a patient in whom this disease is suspected referred to a specialized unit.

• MeSH
• diagnostické zobrazování MeSH
• hematologické nádory diagnostické zobrazování   diagnóza   MeSH
• lidé MeSH
• melanom diagnostické zobrazování   diagnóza   MeSH
• nádorové komplikace v těhotenství * diagnóza   klasifikace   MeSH
• nádory děložního čípku diagnóza   MeSH
• nádory štítné žlázy diagnostické zobrazování   diagnóza   MeSH
• nádory vaječníků diagnostické zobrazování   diagnóza   MeSH
• těhotenství MeSH
• Check Tag
• lidé MeSH
• těhotenství MeSH
• ženské pohlaví MeSH
• Publikační typ
• práce podpořená grantem MeSH