Malignancies during Pregnancy – A Case Series and a Brief Review of Literature

Abstract

Although occurrence of malignancy in pregnancy is rare, it accounts for a third of all maternal deaths during gestation. The advances in reproductive medicine and deliberate postponement of pregnancy till a later age may show a rise in the incidence of malignancies in pregnancy in future. Lack of standard guidelines is a major hurdle in the management of cancer in pregnancy. Our aim was to do a retrospective analysis of all cases treated at our institute with malignancy diagnosed during pregnancy and to analyze the treatment and the maternal and fetal outcomes. All patients with histologically proven malignancy diagnosed during pregnancy treated at our institute from January 2006 till December 2010 were included in the analysis. There were 21 patients with malignancy diagnosed during pregnancy. Their mean age was 28.2 years and mean gestational age 25 weeks at presentation. Four patients opted for medical termination of pregnancy and three patients underwent elective preterm deliveries before treatment. One patient refused treatment and the remaining 13 patients had treatment during pregnancy or delivery. There were no fetal or neonatal complications in the treated group. Coexistence of malignancy with pregnancy poses a diagnostic and therapeutic challenge. Delay in diagnosis is due to symptoms of disease being mistaken for benign symptoms of pregnancy. Management principles are similar for the corresponding stage of malignancy in a non-pregnant patient