Supportive Care

Chapter 1 - Cancer Treatment during Pregnancy

Nausea and vomiting

Active or proactive treatment with metoclopramide, domperidone or ondansteron is possible throughout the pregnancy period. Prednisone could also be used, but preferably during the second trimester.

Pain

Paracetamol is the analgesic of choice. Non-steroidal anti-inflammatory drugs (NSAIDs) should be avoided, as they are associated with foetal defects, risk of miscarriage and oligohydramnios. Opiates could be used in cases of severe pain, but they are better avoided close to delivery, as they can be associated with neonatal withdrawal effects.

Infections

Cephalosporins, metronidazole and clarithromycin could be used safely during pregnancy. Limited data are available on imipenem and meropenem. Quinolones and aminoglycosides should be avoided during the course of gestation, as they are associated with foetal congenital malformations.

Anaemia and leukopenia

Erythropoietin and granulocyte-colony stimulating factor (G-CSF) should not be used unless there is an urgent need for them, given the limited safety data on their use during pregnancy.

Osteoporosis and bone metastases

Bisphosphonates were shown to induce foetal skeletal defects in animal models. They can also cause maternal hypocalcaemia, which could affect uterine contractions and hence should be avoided.

Last update: 30 October 2013