Jacob Bar1, Ofer Davidi, Yacov Goshen, Moshe Hod, Itzhak Yaniv, Rafael Hirsch. 1. Perinatal Division and the World Health Organization Collaborating Center for Perinatal Care, the Department of Obstetrics and Gynecology, Rabin Medical Center, Petah Tiqva, Israel. jbar@clalit.org.il
Abstract
OBJECTIVE: Pregnancy outcome and the effect of pregnancy on cardiac function were assessed in women cured of childhood cancer. STUDY DESIGN: Forty women who received doxorubicin as part of a chemotherapy protocol for a neoplastic disorder in childhood were followed up at the same center during pregnancy and after delivery. RESULTS: Thirty-seven women (72 pregnancies) completed follow-up. Pregnancy outcome was favorable in the 29 women with fractional shortening values of >or=30% before pregnancy, and their myocardial function was sustained. In 8 women with fractional shortening of <30% before pregnancy, pregnancy outcome was less favorable; a 19% decrease in fractional shortening was observed after pregnancy, and this finding was not significant (P=.08). CONCLUSION: Pregnancy outcome in women who received doxorubicin for malignancy in childhood is generally favorable. However, those with baseline left ventricular dysfunction should be considered at increased risk for worse pregnancy outcome and further deterioration in myocardial function.
OBJECTIVE: Pregnancy outcome and the effect of pregnancy on cardiac function were assessed in women cured of childhood cancer. STUDY DESIGN: Forty women who received doxorubicin as part of a chemotherapy protocol for a neoplastic disorder in childhood were followed up at the same center during pregnancy and after delivery. RESULTS: Thirty-seven women (72 pregnancies) completed follow-up. Pregnancy outcome was favorable in the 29 women with fractional shortening values of >or=30% before pregnancy, and their myocardial function was sustained. In 8 women with fractional shortening of <30% before pregnancy, pregnancy outcome was less favorable; a 19% decrease in fractional shortening was observed after pregnancy, and this finding was not significant (P=.08). CONCLUSION: Pregnancy outcome in women who received doxorubicin for malignancy in childhood is generally favorable. However, those with baseline left ventricular dysfunction should be considered at increased risk for worse pregnancy outcome and further deterioration in myocardial function.
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