Abstract
BackgroundCancer during pregnancy is relatively rare but may lead to maternal mortality. We aimed to assess the incidence of cancer related maternal mortality and the neonatal outcome in these patients. Also, doctor- and patient-related delay in cancer diagnosis and therapy among patients with cancer related maternal mortality is assessed.MethodsMaternal mortality was defined as death during pregnancy or within 1 year after delivery. Data of the Dutch Maternal Mortality Committee was used to calculate the cancer related maternal mortality rate and to assess neonatal outcome in the Netherlands. Delay was scored by ten medical specialist based on case descriptions.ResultsCancer related maternal mortality rate was 1.23 per 100,000 live births. Delay in either diagnosis or treatment occurred in 65%. Delay in diagnosis was more frequent then delay in treatment, and was mainly caused by health care providers. Only 77% of pregnancies were ongoing, and 65% ended preterm of which 85% was induced.ConclusionsAvoiding delay in diagnosis and therapy in case of pregnancy related cancer could potentially improve maternal and neonatal outcome. It is therefore essential to increase awareness among health care providers about the occurrence and recurrence of cancer in pregnancy and the possibilities of diagnostic and therapeutic interventions in these women.
Highlights
Cancer during pregnancy is relatively rare but may lead to maternal mortality
If standard therapy is started without delay, prognosis of pregnant patients is comparable to non-pregnant patients when corrected for maternal age and stage
Maternal mortality is defined as death occurring during pregnancy or within the first year after delivery
Summary
Cancer during pregnancy is relatively rare but may lead to maternal mortality. We aimed to assess the incidence of cancer related maternal mortality and the neonatal outcome in these patients. Doctor- and patient-related delay in cancer diagnosis and therapy among patients with cancer related maternal mortality is assessed. If standard therapy is started without delay, prognosis of pregnant patients is comparable to non-pregnant patients when corrected for maternal age and stage. Cancer related symptoms can mimic those of physiological pregnancy changes [4] They may be interpreted by both patient and health care providers as pregnancy related, delaying an accurate diagnosis [5, 6]. This delay can lead to a more advanced stage of disease, causing a higher mortality rate [7]
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