Cancer et grossesse: Aspects épidémiologiques et thérapeutiques

Having to start chemotherapy during pregnancy is a rare event. The decision to proceed with this treatment depends on the drugs used, how long the foetus will be exposed to them and the gestational age at the time of exposure. It is important to know the mutagenicity potential of the chosen medicine, and consequently, the risk for the child, without putting the mother's life or health at risk. This issue mainly involves breast cancer, leukemia and lymphoma. The first trimester of pregnancy is the most critical period for the foetus, as this is when organogenesis occurs. Antimetabolites are the drugs most linked with the risk of malformation. In addition, chemotherapy may have a directly toxic effect on the foetus in utero. Myelosuppression is the most common of these, causing infections and/or foetal haemorrhage. The long term risks of cancer on fertility or the child's intellectual development are still not well known and must be included in prospective studies, as well as being recorded in a specific data file.