Pregnancy after chemoradiotherapy in childhood: Complications and recommendations - about one case

J Gynecol Obstet Hum Reprod. 2021 Jan;50(1):101947. doi: 10.1016/j.jogoh.2020.101947. Epub 2020 Oct 16.

Abstract

The question of pregnancy prognosis after radio chemotherapy is unaddressed. We report here the case of three successive spontaneous pregnancies 17 years after the management of a thigh rhabdomyosarcoma treated by radiochemotherapy. In 2018 the patient aged 22 presented with a spontaneous miscarriage. In 2019, she obtained a new spontaneous pregnancy. At 21 W G, she presented with threatened late miscarriage and gave birth to a live girl who would die. Three months after delivery, she had spontaneous pregnancy. At 18 W G, emergency cervical cerclage was performed. At 35 W G the ultrasound found severe intrauterine growth retardation. Cesarean section was performed allowing the birth of a girl in good health status. Childbirth was complicated by 1L8 postpartum hemorrhage secondary to uterine atony, controlled after surgical revision. To conclude, pregnancy in a patient with a history of pelvic irradiation in childhood must be considered high-risk pregnancy and its management must be multidisciplinary.

Keywords: High-risk pregnancy; Intrauterine growth retardation; Miscarriage; Post-partum hemorrhage; Radio chemotherapy; Uterine fibrosis.

Publication types

  • Case Reports

MeSH terms

  • Abortion, Spontaneous
  • Cerclage, Cervical
  • Cesarean Section
  • Chemoradiotherapy*
  • Female
  • Fetal Growth Retardation
  • Humans
  • Postpartum Hemorrhage / surgery
  • Pregnancy
  • Pregnancy, High-Risk*
  • Rhabdomyosarcoma / therapy
  • Soft Tissue Neoplasms / therapy
  • Stillbirth
  • Uterine Inertia / surgery
  • Young Adult