Gynaecological malignancies in pregnancy

Reviews in Gynaecological Practice Pub Date : 2004-09-01 DOI:10.1016/j.rigp.2004.03.002

V. Sivanesaratnam

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引用次数: 8

Abstract

Malignancies of the genital tract in pregnancy are uncommon. When they are encountered in pregnancy there is always a conflict between optimal maternal therapy and fetal well-being. In most instances the cancer should be managed as though the patient were not pregnant. Surgery is preferred for the various site-specific cancers; the timing and mode of delivery should be individualised. The commonest gynaecological cancer encountered is cervical cancer. Delivery by classical Caesarean section followed by radical hysterectomy appears to be the method of choice for cervical cancer; significantly poorer survivals were observed if this was delayed until the puerperium.

Ovarian cancer, the second most common gynaecological cancer in pregnancy has a good prognosis due to early presentation in the majority. Malignant germ-cell tumours are just as common as epithelial ovarian cancers.

The association of pregnancy with other gynaecological malignancies—carcinoma of endometrium, vagina, fallopian tube, vulva, and choriocarcinoma are discussed.

Cytotoxic drugs are highly teratogenic in the first trimester; other fetal problems can arise when these are used after 12 weeks’ gestation. Therefore, cytotoxic chemotherapy is best avoided in pregnancy.

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妊娠期妇科恶性肿瘤

妊娠期生殖道恶性肿瘤并不常见。当它们在怀孕期间遇到时，总是存在最佳母亲治疗与胎儿健康之间的冲突。在大多数情况下，应该把癌症当作没有怀孕的病人来处理。手术是治疗各种部位特异性癌症的首选方法;交付的时间和方式应该个性化。最常见的妇科癌症是子宫颈癌。传统的剖腹产后根治性子宫切除术似乎是宫颈癌的首选方法;如果延迟到产褥期，观察到存活率明显较差。卵巢癌是妊娠期第二大常见妇科癌症，多数因发病早，预后良好。恶性生殖细胞肿瘤和上皮性卵巢癌一样常见。妊娠与其他妇科恶性肿瘤的关系-子宫内膜癌、阴道癌、输卵管癌、外阴癌和绒毛膜癌的讨论。细胞毒性药物在妊娠早期具有高度致畸性;当这些在妊娠12周后使用时，可能会出现其他胎儿问题。因此，怀孕期间最好避免使用细胞毒性化疗。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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