An audit of the maternal medicine clinic: Cancer and pregnancy

Author:

Harrison Mia1,Umstad Mark P.234,Cui Wanda56,Thevathasan Iniyaval1ORCID,Price Sarah A.L.78910ORCID

Affiliation:

1. Department of Obstetrics and Gynaecology Royal Women's Hospital Melbourne Victoria Australia

2. Department of Maternal Fetal Medicine Royal Women's Hospital Melbourne Victoria Australia

3. Department of Obstetrics and Gynaecology University of Melbourne Melbourne Victoria Australia

4. Consultative Council on Obstetric and Paediatric Mortality and Morbidity Safer Care Victoria Melbourne Victoria Australia

5. Department of Oncology Peter MacCallum Cancer Centre Melbourne Victoria Australia

6. Sir Peter MacCallum Department of Oncology University of Melbourne Melbourne Victoria Australia

7. Department of Medicine University of Melbourne Melbourne Victoria Australia

8. Department of Obstetric Medicine Royal Women's Hospital Melbourne Victoria Australia

9. Frances Perry House Melbourne Victoria Australia

10. Department of Diabetes and Endocrinology Royal Melbourne Hospital Melbourne Victoria Australia

Abstract

AbstractAimsTo explore the incidence and complexity of women presenting for maternity care who require concurrent cancer care, and to report the birth outcomes of these women.Materials and MethodsA retrospective audit of women attending a ‘high risk’ maternal medicine clinic at an Australian tertiary maternity hospital between 1 October 2021 and 30 April 2023 was conducted. The inclusion criteria were a diagnosis of cancer and a concurrent pregnancy, or a diagnosis of cancer prior to the current pregnancy. Clinic lists and coding data were screened via the electronic medical record to identify potential subjects. Data were collected from the individual maternity and neonatal records.ResultsForty of 705 (5.7%) women attending the maternal medicine clinic met the inclusion criteria, of which ten had a new diagnosis of cancer in pregnancy and 30 presented for maternity care after a previous diagnosis of cancer. Cancer therapy during pregnancy included surgery and chemotherapy. Most pregnancies (92.5%) resulted in term deliveries (≥37 weeks gestation). Four neonates were preterm, and one was small‐for‐gestational‐age. Caesarean section delivery and post‐partum haemorrhage were more common than expected, but the rate of other adverse pregnancy outcomes was consistent with the background population. Over half of neonates required neonatal intensive care unit / special care nursery admission but the indications for admission were common, self‐limiting conditions, and the length of stay was short (mean <5.0 days).ConclusionsApproximately 6% of women attending the maternal medicine clinic had a current or previous diagnosis of cancer. Most pregnancies resulted in term deliveries and neonatal outcomes were excellent.

Funder

National Health and Medical Research Council

Publisher

Wiley

Subject

Obstetrics and Gynecology,General Medicine

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