A pilot study on peak systolic velocity monitoring of fetal anemia after administration of chemotherapy during pregnancy

Halaška, Michael; Komar, M; Vlk, R.; Tomek, Viktor; Skultety, J.; Robová, Helena; Rob, Lukáš

doi:10.1016/j.ejogrb.2013.12.021

Cited by 14 publications

(13 citation statements)

References 19 publications

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“…They measured the MCA PSV one day before and the third day after chemotherapy. No severe range fetal anemia was diagnosed but they found a number of cases of mild fetal anemia which supports the use of MCA Dopplers in monitoring pregnancies treated with chemotherapy [ 9 ]. The 2015 guidelines published in the British Journal of Haematology recommend serial ultrasounds every 4 weeks for growth and fetal well-being to monitor for growth restriction.…”

Section: Commentmentioning

confidence: 83%

“…Utilizing MCA peak systolic velocity (PSV), fetal anemia can be diagnosed via noninvasive methods. Studies have demonstrated that a threshold of 1.5 MoM is suggestive of moderate to severe fetal anemia [ 9 ]. In 2014, a study evaluated the use of MCA Dopplers for monitoring of fetal anemia when chemotherapy is administered to pregnant women with ovarian, cervical, or breast cancer.…”

Section: Commentmentioning

confidence: 99%

See 1 more Smart Citation

Undetected Severe Fetal Myelosuppression following Administration of High-Dose Cytarabine for Acute Myeloid Leukemia: Is More Frequent Surveillance Necessary?

Parrott

Holland

2017

Case Reports in Obstetrics and Gynecology

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Background Cytarabine use during pregnancy carries a 5–7% risk of neonatal cytopenia. We report two cases of fetal myelosuppression following high-dose cytarabine administration for acute myeloid leukemia (AML). Case 1 A 36-year-old G9P6 diagnosed with AML at 21 weeks was monitored for fetal anemia weekly and growth monthly. At 33 weeks (after 2 cycles), BPP was 2/10 and MCA PSV was elevated at 1.51 MoM. Urgent cesarean section was performed. The infant had an initial pH of 6.78 and pancytopenia (hematocrit 13.3%, platelets 3 K/UL, and white blood cell count 2.0 K/UL). Initially transfusion dependent, the neonate had count recovery by 3 weeks. Case 2 A 30-year-old G4P3 with AML at 26 weeks was monitored for fetal anemia twice weekly and growth monthly. At 34 weeks (after cycle 1), she was admitted with neutropenic fever. The fetal MCA PSV was borderline at 1.48 MoM. It improved to 1.38 MoM at 35 weeks but the fetal tracing worsened. At delivery the fetus was found to have a hematocrit of 30%, but with normal platelet and WBC. The fetus did not require any transfusions. Conclusion Cytarabine use during pregnancy may cause neonatal myelosuppression. We recommend monitoring for fetal anemia with MCA Dopplers twice weekly.

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Section: Commentmentioning

confidence: 83%

Section: Commentmentioning

confidence: 99%

Undetected Severe Fetal Myelosuppression following Administration of High-Dose Cytarabine for Acute Myeloid Leukemia: Is More Frequent Surveillance Necessary?

Parrott

Holland

2017

Case Reports in Obstetrics and Gynecology

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“…45 Hematological toxicity can result in an augmented risk for infections and bleeding complications during delivery. 46 The main message for the use of cytostatics during pregnancy is that the treatment of a patient with ovarian cancer is with an optimal treatment regimen without harm to the developing fetus. The treatment for EOC should consist of surgical staging and chemotherapy (in all patients apart from staging IA, grade 1-2).…”

Section: Systematic Treatmentmentioning

confidence: 99%

“…Halaska et al have demonstrated its potential use in monitoring fetal anemia. 46 Using multiples of the median of PSV authors were able to predict the severity of fetal anemia. Significant obstetric risk is always present in emergency situations, eg, ovarian torsion.…”

Section: Follow-upmentioning

confidence: 99%

Approaches to the Diagnosis and Management of Ovarian Cancer in Pregnancy

Michalczyk¹,

Cymbaluk‐Płoska²

2021

CMAR

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Ovarian cancer is one of the most common gynecological cancers diagnosed in pregnancy. Its management is often very problematic due to the proximity of the adnexa to the developing fetus and chemotherapy-related toxicity risk. Tumor markers and imagining studies play important roles in diagnosis, help differentiate benign masses from malignancy and allow to plan the treatment. Due to the physiological changes that occur in pregnancy, levels of tumor markers can be altered and reduce their diagnostic value. We review current recommendations for the management and treatment of ovarian cancer in pregnant patients considering gestational age at diagnosis, tumor histology, stage of the disease, risk of obstetrical complications, and patient’s preferences.

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“…Ultrasound fetal examination with the assessment of growing intervals, amniotic fluid index (AFI), cervical length and Doppler exam of blood flows in the middle cerebral artery (MCA) and umbilical artery (UA) seems obligatory [73]. The assessment of the peak systolic velocity (PSV) in the MCA is of great clinical value in the care of high-risk pregnancies for the diagnosis and management of fetal anemia and intrauterine growth restriction (IUGR) [74]. Supplementation of folic acid and nutritional counseling is also essential to optimize maternal and fetal status.…”

Section: Obstetric Outcomesmentioning

confidence: 99%

Ovarian Cancer and Pregnancy—A Current Problem in Perinatal Medicine: A Comprehensive Review

Dłuski

Mierzyński

Poniedziałek‐Czajkowska

et al. 2020

Cancers

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The frequency of concomitant adnexal tumors in pregnancy is reported to be at 0.15–5.7%, while ovarian cancer complicates 1 in 15,000 to 1 in 32,000 pregnancies, being the second most common gynecologic cancer diagnosed during pregnancy. The aim of this review is to discuss the problem of ovarian cancer complicating pregnancy and the current recommendations for diagnostics and treatment, with an emphasis on the risk to the fetus. A detailed analysis of the literature found in the PubMed and MEDLINE databases using the keywords “ovarian cancer”, “ovarian malignancy”, “adnexal masses”, “ovarian tumor” and “pregnancy” was performed. There were no studies on a large series of pregnant women treated for ovarian malignancies and the management has not been well established. The diagnostics and therapeutic procedures need to be individualized with respect to the histopathology of the tumor, its progression, the gestational age at the time of diagnosis and the mother’s decisions regarding pregnancy preservation. The multidisciplinary cooperation of specialists in perinatal medicine, gynecological oncology, chemotherapy, neonatology and psychology seems crucial in order to obtain the best possible maternal and neonatal outcomes.

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A pilot study on peak systolic velocity monitoring of fetal anemia after administration of chemotherapy during pregnancy

Cited by 14 publications

References 19 publications

Undetected Severe Fetal Myelosuppression following Administration of High-Dose Cytarabine for Acute Myeloid Leukemia: Is More Frequent Surveillance Necessary?

Undetected Severe Fetal Myelosuppression following Administration of High-Dose Cytarabine for Acute Myeloid Leukemia: Is More Frequent Surveillance Necessary?

Approaches to the Diagnosis and Management of Ovarian Cancer in Pregnancy

Ovarian Cancer and Pregnancy—A Current Problem in Perinatal Medicine: A Comprehensive Review

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