1527P_PR - Unplanned pregnancy during cancer treatment - on behalf of the International Network of Cancer, Infertility and Pregnancy (INCIP)

Date 28 September 2014
Event ESMO 2014
Session Poster Display session
Topics Cancer in Pregnancy
Presenter Sarah van Peer
Citation Annals of Oncology (2014) 25 (5): 1-41. 10.1093/annonc/mdu438
Authors S. van Peer1, S.N. Han2, K.D. Steffensen3, M.J. Halaska4, M.M. Gziri5, K. van Calsteren6, F. Amant7
  • 1Gynaecology, UZ Leuven, 3000 - Leuven/BE
  • 2Gynecological Oncology, KU Leuven, 3000 - Leuven/BE
  • 3Gynaecological Oncology, University of Southern Denmark, Odense/DK
  • 4Gynaecological Oncology, 2nd Medical Faculty, Charles University, Prague/CZ
  • 5Gynaecological Oncology, UCL, Louvain-La-Neuve/BE
  • 6Obstetrics And Gynaecology, UZ Leuven, Leuven/BE
  • 7Gynaecological Oncology, KU Leuven, 3000 - Leuven/BE

Abstract

Aim

To assess unplanned pregnancies during cancer diagnosis and treatment.

Methods

Retrospective review of patients who became pregnant during cancer diagnosis or cancer treatment. The prospective European registration study of INCIP was used.

Results

We found a total of 29 patients. Type of malignancy was: breast cancer (n= 17; 58.6%), acute myeloid leukemia (n = 4; 13.7%), Ewing sarcoma (n = 1; 3.4%), cervical cancer (n = 2; 6.8%), thyroid cancer (n = 2; 6.8%), ovarian cancer (n= 1; 3.4%), glioblastoma (n= 1; 3.4%), Hodgkin's lymphoma (n = 1; 3.4%). Mean age was 33.7 years (range 16-48); mean gestational age was 8.7 weeks (range 4-26) at discovery of the pregnancy. Pregnancy outcome was as follows: termination of pregnancy (TOP) (n = 9; 31%), spontaneous abortion (n = 2; 7%), extrauterine pregnancy (n = 1; 3%), and live birth (n = 17; 58.6%). Mean gestational age at delivery was 38.2 weeks (range 34.3-41.6) and at TOP 8 weeks (range 4-15). Of the 29 women who became pregnant 12 (41.4%) were not using contraception, contraception failed in 7 (24.1%) and contraceptive use was unknown in 10 (34.5%). The type of failed contraception was: condom (n = 2; 29%), hormonal contraceptive (n = 2; 29%), ovarian ablation with goserlin (n = 1; 14%), radiosterilization (n = 1; 14%). Only 1 patient continued the pregnancy in this group and change of cancer treatment was not needed. In the group not using contraception, 9 women (75%) continued the pregnancy, of which 6 cancer treatment alterations were made. In relation to the oncological diagnosis and treatment, the diagnosis of the pregnancies was made in 3 patients (10.3%) during diagnostic examinations for suspected malignancy but before definite diagnosis, 18 (62%) became pregnant during cancer treatment (3 hormone therapy, 4 radiotherapy, 4 surgery, 3 chemotherapy, 2 immunotherapy, 1 other, 1 unknown) and 7 (24.1%) after diagnosis but before treatment. Contraception after pregnancy is discussed with 18 women (62%) and started in 12 women (unknown n = 11; 38%).

Conclusions

Adequate contraception need to be discussed with young women diagnosed with cancer. This demands education of oncology teams and awareness.

Disclosure

All authors have declared no conflicts of interest.