Monday, 7 April 2014

Special circumstances In pregnancy

The incidence of concurrent cancer during pregnancy has risen due to the increasing age of pregnant mothers[23] and due to the incidental discovery of maternal tumors during prenatal ultrasound examinations.
Cancer treatment needs to be selected to do least harm to both the woman and her embryo/fetus. In some cases a therapeutic abortion may be recommended.
Radiation therapy is out of the question, and chemotherapy always poses the risk of miscarriage and congenital malformations.[23] Little is known about the effects of medications on the child.
Even if a drug has been tested as not crossing the placenta to reach the child, some cancer forms can harm the placenta and make the drug pass over it anyway.[23] Some forms of skin cancer may even metastasize to the child's body.[23]
Diagnosis is also made more difficult, since computed tomography is infeasible because of its high radiation dose. Still, magnetic resonance imaging works normally.[23] However, contrast media cannot be used, since they cross the placenta.[23]
As a consequence of the difficulties to properly diagnose and treat cancer during pregnancy, the alternative methods are either to perform a Cesarean section when the child is viable in order to begin a more aggressive cancer treatment, or, if the cancer is malignant enough that the mother is unlikely to be able to wait that long, to perform an abortion in order to treat the cancer.[23]

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