Cancer during pregnancy: Proposal of a clinical care pathway based on a regional cohort

Objectives. - Cancer during pregnancy affects 1 in 1000 pregnancies. This situation requires multidisciplinary team, however there is no care pathway dedicated to these patients. The main objective was to describe oncological, obstetrical, and neonatal care through a regional inventory. Our secondary objective was to define a regional cancer and pregnancy care pathway.Material and method. - We carried out an observational, retrospective study from 2013 to 2019 including 48 women (all cancer types) from 2013 to 2019 in Occitania. Then, we defined an optimal care pathway and we assessed whether it was respected in the breast cancer subgroup of our cohort.Results. - Live births occurred in 79% of the women included. Maternal treatment was initiated during pregnancy for 67% of our population (44% chemotherapy). The most frequent pregnancy complication was preterm delivery (39%), mainly iatrogenic (86.6%). No patient in the group of breast cancer benefited from all of the ten criteria of the optimal care pathway that we proposed. Conclusions. - A coordinated regional care pathway seems necessary to optimize communication between the healthcare providers (oncologists, gynecologists and multidisciplinary prenatal diagnosis centers, pharmacologists, pediatricians, psychologists, and general practitioners). This study identifies weaknesses in the management of women with cancer during pregnancy and suggests regional improvement opportunities.(c) 2022 Elsevier Masson SAS. All rights reserved.

Automated summary

This study describes the situation of cancer patients during pregnancy in terms of oncological, obstetrical, and neonatal care, and proposes suggestions for optimizing the care pathway. It identifies some weaknesses in the management of cancer patients during pregnancy and suggests regional improvement opportunities.