| The therapeutic management of a twin pregnancy complicated by the presence of cervical cancer, following laparoscopic staging and chemotherapy, with an emphasis on cisplatin concentrations in the fetomaternal compartments amnion fluid, umbilical cord, and maternal serum. | |
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MedLine Citation:
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PMID: 19765705 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVE: To evaluate the feasibility, toxicity, and pharmacokinetics in the maternal and fetal compartments during chemotherapy in a pregnant patient with cervical cancer. DESIGN: Case report. SETTING: University Hospital. PATIENT: A 35-year-old woman was diagnosed with an adenocarcinoma FIGO stage IB1 of the cervix uteri at 14 weeks' gestation with twin pregnancy. INTERVENTION(S): A laparoscopic transperitoneal pelvic lymphadenectomy was performed at 15 weeks' gestation There was no evidence of lymph node metastases (0/19). The patient decided to continue her pregnancy. Three cycles of neoadjuvant chemotherapy consisting of cisplatin during the second and third trimester were given and well tolerated. Amniocentesis was performed at the time of the second cisplatin cycle. MAIN OUTCOME MEASURE(S) AND RESULT(S): The concentration in the amniotic fluid samples reached 10% of the maternal blood levels at this time. At 32 weeks' gestation, a Caesarean section followed by radical hysterectomy was performed. The twins developed normally and displayed no chemotherapically related side effects. At the time of delivery, the corresponding concentration in the amniotic fluid was approximately one-third of the umbilical cord levels. CONCLUSION(S): To our knowledge, this is the first report quantifying the amount of transplacental transport of cisplatin during pregnancy in vivo. One-tenth of the maternal serum concentration was detected in the amniotic fluid; the concentration of cisplatin in the umbilical cord was three times higher than in the amniotic fluid. |
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Authors:
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Simone Marnitz; Alexander Schmittel; Juliane Bolbrinker; Frank-Peter Schmidt; Guus Fons; Karim Kalache; Achim Schneider; Christhardt Köhler |
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Publication Detail:
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Type: Case Reports; Evaluation Studies; Journal Article Date: 2009-09-18 |
Journal Detail:
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Title: Fertility and sterility Volume: 92 ISSN: 1556-5653 ISO Abbreviation: Fertil. Steril. Publication Date: 2009 Nov |
Date Detail:
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Created Date: 2009-11-02 Completed Date: 2009-11-23 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 0372772 Medline TA: Fertil Steril Country: United States |
Other Details:
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Languages: eng Pagination: 1748.e1-4 Citation Subset: IM |
Affiliation:
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Charité University Hospital, Department of Radiooncology, Berlin, Germany. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Adenocarcinoma
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drug therapy*,
metabolism,
pathology* Adult Amniotic Fluid / chemistry, metabolism Antineoplastic Agents / therapeutic use Cisplatin / analysis, blood, pharmacokinetics, therapeutic use* Feasibility Studies Female Fetal Blood / chemistry, metabolism Humans Laparoscopy Maternal-Fetal Exchange / drug effects Mothers Neoplasm Staging / methods Osmolar Concentration Pregnancy Pregnancy Complications, Neoplastic / drug therapy, pathology Pregnancy, Multiple* / drug effects Twins Uterine Cervical Neoplasms / drug therapy*, metabolism, pathology* |
| Chemical | |
Reg. No./Substance:
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0/Antineoplastic Agents; 15663-27-1/Cisplatin |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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