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      Carcinoma in Pregnancy: What is the Impact on Fetus?

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          ABSTRACT

          Cancer association with pregnancy (CAP) is defined as cancer diagnosed from the 1st day of childbearing to 1 year postpartum. Malignant disease in pregnancy is rare, 1:1000 pregnancies, but it represents an important therapeutic and ethical problem for both, the patient and the physician. The most important goals in curing are—treating the patient with the optimal anticancer regimen as soon as possible in order to preserve the mother's health, without harming the developing fetus. Until recently, the pregnancy had to be either terminated or cancer treatment delayed until after the birth. Nowadays, state-of-art treatment should be provided for this vulnerable population to preserve maternal and fetal prognosis.

          When suspicion of malignant disease in pregnancy is grounded, it is necessary to prove the same. It is recommended to apply standard methods, if possible. With some malignant tumors, some protocols for establishing diagnosis are changing sensitivity and specificity in pregnancy.

          Ultrasound examination is a method of choice for the breast, abdomen, and pelvis. If necessary, chest X-ray and mammography can be done safely with abdominal shielding. Magnetic resonance imaging (MRI) may be conducted if there is any unclarity in the analysis or suspicion of brain or bone metastasis. The main challenge in managing cancer in pregnancy is treating the patient with an optimal anticancer regimen without harming the developing fetus.

          Cancer during pregnancy is associated with a significantly increased risk of planned preterm birth, induction of labor, and a cesarean section. Women with CAP need psychological support during the pregnancy and after delivery.

          How to cite this article

          Crnogorac S, Vuksanovic Bozaric A. Carcinoma in Pregnancy: What is the Impact on Fetus? Donald School J Ultrasound Obstet Gynecol 2023;17(2):136–142.

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          Quality initiatives: guidelines for use of medical imaging during pregnancy and lactation.

          The use of computed tomography (CT) and magnetic resonance (MR) imaging has increased tremendously in the past 2 decades. Hence, pregnant and breast-feeding women, although generally healthier than the population at large, are also more likely to require contrast material-enhanced imaging. When a contrast-enhanced CT or MR imaging study is being considered for a pregnant or lactating patient, the potential risks to the fetus related to exposure to radiation, high magnetic fields, or contrast agents must be considered and weighed carefully against the risks of potential misdiagnosis due to withholding contrast agents and imaging studies. Fetal radiation doses up to 1 mGy are considered acceptable; with larger doses, the risk of carcinogenesis approximately doubles, although it remains low in absolute terms. No damage to a developing human fetus caused by MR imaging exposure has been documented. However, caution is advised, and risks and benefits must always be considered before evaluating a pregnant patient with MR imaging. The use of iodinated contrast agents is generally safe during pregnancy; nevertheless, these agents should be used with caution due to the risk of fetal hypothyroidism and should be administered only when the clinical situation clearly requires doing so. The use of gadolinium-based contrast agents during pregnancy remains controversial due to lack of human clinical data and potential toxicity. Use of all contrast agents is considered safe during lactation. It is hoped that this knowledge will help radiologists develop a consensus with their clinical colleagues regarding case management of pregnant and lactating patients.
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            • Record: found
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            Guidelines for diagnostic imaging during pregnancy and lactation.

            (2024)
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              Metastatic melanoma in pregnancy: risk of transplacental metastases in the infant.

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                Author and article information

                Journal
                DSJUOG
                Donald School Journal of Ultrasound in Obstetrics and Gynecology
                Donald School J Ultrasound Obstet Gynecol
                Jaypee Brothers Medical Publishers
                0973-614X
                0975-1912
                April-June 2023
                : 17
                : 2
                : 136-142
                Affiliations
                [1 ]Department of Obstetrics & Gynecology, Faculty of Medicine, University of Montenegro, Podgorica, Montenegro
                [2 ]Department of Anatomy, Faculty of Medicine, University of Montenegro, Podgorica, Montenegro
                Author notes
                Snezana Crnogorac, Department of Obstetrics & Gynecology, Faculty of Medicine, University of Montenegro, Podgorica, Montenegro, Phone: +38269018152, e-mail: snezanacrnogorac1@ 123456gmail.com
                Article
                10.5005/jp-journals-10009-1972
                7e4f153d-ee04-437a-a2d2-e0883604e281
                Copyright © 2023; The Author(s).

                © The Author(s). 2023 Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( https://creativecommons.org/licenses/by-nc/4.0/), which permits unrestricted use, distribution, and non-commercial reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

                History
                : 25 March 2023
                : 20 April 2023
                : 30 June 2023
                Categories
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                Custom metadata
                dsjuog-17-136.pdf

                Obstetrics & Gynecology
                Treatment,Pregnancy,Malignant disease
                Obstetrics & Gynecology
                Treatment, Pregnancy, Malignant disease

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