M J Halaska1, M Komar2, R Vlk2, V Tomek3, J Skultety2, H Robova2, L Rob2. 1. Department of Obstetrics and Gynecology, 2nd Medical Faculty, Charles University in Prague, Czech Republic. Electronic address: mhalaska@seznam.cz. 2. Department of Obstetrics and Gynecology, 2nd Medical Faculty, Charles University in Prague, Czech Republic. 3. Department of Children Cardiocenter, 2nd Medical Faculty, Charles University in Prague, Czech Republic.
Abstract
OBJECTIVES: To monitor fetal anemia during administration of chemotherapy to the fetus's mother. STUDY DESIGN: Between 2007 and 2012 six patients with malignancy diagnosed during pregnancy were included in our prospective study. For evaluation of fetal anemia, peak systolic velocimetry (PSV) of the middle cerebral artery is considered the best method. The patients were repeatedly examined one day before and on the third day after the administration of chemotherapy. At least three measurements were performed and the highest value was used as appropriate. Multiples of the median (MoM) were calculated using the website http://www.perinatology.com/calculators/MCA.htm. When the MoM reached 1.29, moderate anemia was diagnosed. RESULTS: The women's average age was 30 years. The average gestational age at diagnosis was 20.7 weeks of pregnancy. Borderline fetal anemia was detected in only in one patient. After delivery newborns were examined by standard pediatric evaluation and blood count was provided. There was no evidence of any newborn anemia. CONCLUSIONS: Chemotherapy administered during pregnancy is becoming more frequent due to increasing knowledge and data on such cases. Close monitoring of the fetus should be performed in specialized centers. For detection of chemotherapy-induced anemia, PSV measurement should be employed.
OBJECTIVES: To monitor fetal anemia during administration of chemotherapy to the fetus's mother. STUDY DESIGN: Between 2007 and 2012 six patients with malignancy diagnosed during pregnancy were included in our prospective study. For evaluation of fetal anemia, peak systolic velocimetry (PSV) of the middle cerebral artery is considered the best method. The patients were repeatedly examined one day before and on the third day after the administration of chemotherapy. At least three measurements were performed and the highest value was used as appropriate. Multiples of the median (MoM) were calculated using the website http://www.perinatology.com/calculators/MCA.htm. When the MoM reached 1.29, moderate anemia was diagnosed. RESULTS: The women's average age was 30 years. The average gestational age at diagnosis was 20.7 weeks of pregnancy. Borderline fetal anemia was detected in only in one patient. After delivery newborns were examined by standard pediatric evaluation and blood count was provided. There was no evidence of any newborn anemia. CONCLUSIONS: Chemotherapy administered during pregnancy is becoming more frequent due to increasing knowledge and data on such cases. Close monitoring of the fetus should be performed in specialized centers. For detection of chemotherapy-induced anemia, PSV measurement should be employed.