Acta Medica Medianae
Vojislava Kalanovića IA/3
UNRECOGNIZED PREGNANCY AND CHEMOTHERAPY
Teratogenic potential of cytostatics is directly dependent on pregnancy stage in which they are applied. Without any doubt, teratogenic potential was proved to be the highest in the 1st pregnancy trimester, especially during treatment by polychemotherapy, in range of 10% to 16%, 3% of which goes to large anomalies which attack fetus. The effects related to fetus depend on pregnancy stage, dose quantity and synergism with other medications, as well as on individual reactions to the medication. The role of placental »barrier« causes certain doubts. In the 2nd and 3rd trimester the application of these medications can be the reason of setback in the development in utero, premature birth and neurotoxicity. The area of chemotherapy application in the 2nd pregnancy trimester is definitely the most controversial, because at that moment the termination of pregnancy represents enormous psychological and ethical burden both for the parents and the doctor. If the decision is made to continue the therapy by cytostatics, it can be applied with obligatory informing of parents on potential risks for the fetus. In the 3rd trimester, however, it seems that it is acceptable to postpone the application of cytostatics till after the child is born. The aim of this paper was to present the case of unrecognized pregnancy of the woman in the 24th gestation week after the operation due to colon carcinoma, with verified metastases in the liver and ongoing chemotherapy, whose pregnancy was established accidentally after detection of the skeleton at control native x-ray screening of abdomen in the Clinical Centre Kragujevac. Acta Medica Medianae 2009;48(1):63-65.
Key words: colon carcinoma, chemotherapy, pregnancy