Kanser tedavisi sonrası sağ kalım sürecindeki gebelik olguları; tek tersiyer merkezin deneyimi

Year 2017, Volume: 80 Issue: 3, 98 - 103, 01.09.2017

Ebru Alıcı Davutoğlu , Ayşegül Özel , Rıza Madazlı

https://doi.org/10.18017/iuitfd.363576

Abstract

Amaç: Genç adolesan ve yetişkin dönemde
kanser tedavisi gören kadınların gebeliklerini analiz edip obstetrik ve
neonatal sonuçlarını değerlendirmektir.

Gereç ve Yöntem: Cerrahpaşa Tıp Fakültesi
Kadın Hastalıkları ve Doğum Kliniği’nde Ocak
2000-Aralık 2015 yılları arasında antenatal izlemi yapılan, adolesan ve genç
erişkin dönemde kanser tedavisi görmüş ve izlem sürecinde gebe kalan 68 olgunun
maternal ve perinatal sonuçları, retrospektif olarak değerlendirildi. Kanser
tiplerinin dağılımı, kanser tanısının konulduğu yaş, uygulanan tedavi ve izlem
süresi irdelendi. Maternal sonuçlar; doğum haftası, doğum kilosu ve perinatal
sonuçlar değerlendirildi.

Bulgular: En sık karşılaşılan kanserler,
tiroid kanseri (%26,5), hematolojik maligniteler (%22,5) ve genital kanserler
(%18) olarak saptandı. Olguların ortalama yaşı 31,7±5,5
ve nulliparite oranı %48,5 olarak saptandı. Ortalama doğum haftası 37,5±2,5; ortalama doğum kilosu 3020±717,
37 hafta öncesinde doğum oranı %12,1 iken 34 hafta öncesinde doğum oranı %8,8
olarak tespit edildi. Grubumuzda sezaryen, fetal gelişim kısıtlılığı,
preeklampsi ve gestasyonel diayabet oranları sırasıyla %77,2, %5,8, %2,9 ve
%8,8 olarak belirlendi. 2 hastada abortus izlenirken, 3 hastaya tıbbi nedenli
tahliye yapıldı. Kansere yakalanma yaş ortalaması en düşük hematolojik
kanserlerde gözlenirken (22,5±6,6) sonrasında iskelet sistemi (26±8,7) ve tiroid kanseri (26,9±5,6) yer aldı.
Hastaların hiçbirinde konjenital fetal anomali izlenmedi.

Sonuç: Kanser tedavisi sonrası gebe kalan
hasta grubunda olumlu obstetrik sonuçlar gözlenmiş olup, bu hastaların gebelik
izlemi, uygun merkezlerde, multidisipliner bir ekiple yapılmalıdır.

Keywords

Gebelik; kanser; kanserden sağ kalım; gebelik sonuçları

Pregnancy in cancer survivors; experience of a single tertiary center

Abstract

Objective: To investigate obstetric and
perinatal outcomes among pregnant female survivors of adolescent and young adult
cancers.

Materials and Methods: A retrospective
analysis of maternal and perinatal outcomes of 68 pregnant women with a history
of cancer who received antenatal care at the Cerrahpasa Medical Faculty
Obstetric and Gynecology Department between January 2000 and  December 2015 was carried out. Perinatal and
maternal outcomes were evaluated according to cancer type, timing of cancer
diagnosis, and treatment modality. The distribution of cancer types, the age at
which the cancer was diagnosed, the treatment modalities, and the duration of
follow-up were analyzed. Maternal and perinatal outcomes were evaluated.

Results: The most
frequently encountered tumor types in pregnant women with a history of cancer
were thyroid cancers (26.5%), hematologic malignancies (22.5%), and genital
cancers (18%). The mean maternal age was 31.7±5.5 years, and the frequency of
nulliparity was 48.5%. The mean gestational age at delivery was 37.5±2.5 weeks,
the mean birth weight was 3020±717 g, and the frequencies of delivery before 37
and 34 weeks were 12.1% and 8.8%, respectively. The incidences of ceaserian
section, fetal growth restriction, preeclampsia, and gestational diabetes were
77.2%, 5.8%, 2.9%, and 8.8%, respectively, in women with a history of cancer.
There were two miscarriages and three terminations of pregnancy in women who
had survived cancer. The lowest mean age at the time of cancer diagnosis was
observed for haematological cancers (22.5±6.6). There were no congenital
anomalies in our group.

Conclusion: Cancer survivors who became
pregnant after cancer treatment had good obstetric outcomes. Pregnancy
follow-up of these patients should be carried out by a multidisciplinary team
at tertiary centers.

Keywords

Pregnancy; cancer; cancer survivor; pregnancy outcome

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