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Seminars in perinatology最新文献

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Cervical cancer in pregnancy
IF 3.2 3区 医学
Seminars in perinatology Pub Date : 2025-03-01 DOI: 10.1016/j.semperi.2025.152038
Charlotte LeJeune , Nathalia Mora-Soto , Lone Storgaard , René Pareja , Frédéric Amant
{"title":"Cervical cancer in pregnancy","authors":"Charlotte LeJeune ,&nbsp;Nathalia Mora-Soto ,&nbsp;Lone Storgaard ,&nbsp;René Pareja ,&nbsp;Frédéric Amant","doi":"10.1016/j.semperi.2025.152038","DOIUrl":"10.1016/j.semperi.2025.152038","url":null,"abstract":"<div><div>Cervical cancer is one of the most common and challenging malignancies diagnosed during pregnancy, requiring a complex balance between effective oncological management and pregnancy preservation. This narrative review synthesizes current evidence and clinical experience regarding the management of cervical cancer in pregnant patients. While treatment should generally follow standard protocols for nonpregnant patients, emerging data suggest that pregnancy can often be safely maintained without compromising oncological outcomes. Nevertheless, robust prognostic data from larger patient cohorts are still needed. Individualized treatment approaches that incorporate the patient's preferences and values are crucial. Given the complexities involved, referral to specialized tertiary centers with expertise in the oncological and obstetric care of pregnant cancer patients is strongly recommended to ensure optimal outcomes for both mother and child.</div></div>","PeriodicalId":21761,"journal":{"name":"Seminars in perinatology","volume":"49 2","pages":"Article 152038"},"PeriodicalIF":3.2,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143610736","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Obstetric and perinatal management in the setting of cancer
IF 3.2 3区 医学
Seminars in perinatology Pub Date : 2025-03-01 DOI: 10.1016/j.semperi.2025.152044
Eve Overton , Gabriela Tessler
{"title":"Obstetric and perinatal management in the setting of cancer","authors":"Eve Overton ,&nbsp;Gabriela Tessler","doi":"10.1016/j.semperi.2025.152044","DOIUrl":"10.1016/j.semperi.2025.152044","url":null,"abstract":"<div><div>Obstetric care for patients with cancer diagnoses during pregnancy is medically and ethically complex, and limited prospective data and national guidelines are available to guide care. Guiding principles for treatment are to optimize maternal outcomes while minimizing neonatal morbidity. Oncologic work- up and management are dependent on the trimester of diagnosis, and are specific to the type, stage, and grade of the oncologic diagnosis. Obstetric care should occur within a multidisciplinary setting, with involvement of maternal fetal medicine, oncologic specialists, and mental health support.</div></div>","PeriodicalId":21761,"journal":{"name":"Seminars in perinatology","volume":"49 2","pages":"Article 152044"},"PeriodicalIF":3.2,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143610741","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Lymphoma and leukemia occurring during pregnancy
IF 3.2 3区 医学
Seminars in perinatology Pub Date : 2025-03-01 DOI: 10.1016/j.semperi.2025.152041
Adam S. Zayac, Ogechukwu Egini, Neil D. Palmisiano, Andrew M. Evens
{"title":"Lymphoma and leukemia occurring during pregnancy","authors":"Adam S. Zayac,&nbsp;Ogechukwu Egini,&nbsp;Neil D. Palmisiano,&nbsp;Andrew M. Evens","doi":"10.1016/j.semperi.2025.152041","DOIUrl":"10.1016/j.semperi.2025.152041","url":null,"abstract":"<div><div>Malignancies arising during pregnancy are an infrequent occurrence, leading to a paucity of data on the optimal management of cancers during pregnancy. Unlike most solid tumors, the primary, and often curative, management of hematologic malignancies relies heavily on multiagent cytotoxic chemotherapies over surgery and other localized therapies, making their management during pregnancy even more complex and hazardous to both mother and fetus. Close multidisciplinary care and coordination between obstetrician, maternal fetal medicine, and oncologists are essential given the dangers to both in the management, from diagnosis and throughout treatment, even through delivery and survivorship. Due to the importance of this topic and the number of lives that could be impacted, guidelines have been published by interdisciplinary expert panels based on available data and clinical experience. This review addresses the management of both Hodgkin and non-Hodgkin lymphomas as well as acute and chronic leukemias. The optimal diagnostic approaches, and therapeutic schemes, including the use of cellular therapies, immunotherapies, targeted and cytotoxic agents, as well as guidance on decision making regarding management of the pregnancy weighing both the maternal and fetal risks and benefits of each approach are discussed herein.</div></div>","PeriodicalId":21761,"journal":{"name":"Seminars in perinatology","volume":"49 2","pages":"Article 152041"},"PeriodicalIF":3.2,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143610738","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Thyroid cancer
IF 3.2 3区 医学
Seminars in perinatology Pub Date : 2025-03-01 DOI: 10.1016/j.semperi.2025.152042
Liyang Tang , Trevor E Angell
{"title":"Thyroid cancer","authors":"Liyang Tang ,&nbsp;Trevor E Angell","doi":"10.1016/j.semperi.2025.152042","DOIUrl":"10.1016/j.semperi.2025.152042","url":null,"abstract":"<div><div>Thyroid cancer encountered during pregnancy requires a systematic approach balancing risks and benefits to both maternal and fetal health specific to this unique phase of life. Thyroid nodules are common and are predominantly evaluated to detect thyroid cancer. Clinical examination, serum thyroid stimulating hormone (TSH) measurement, ultrasonographic risk stratification, and fine needle aspiration biopsy when indicated are used to assess for malignancy. When thyroid cancer is diagnosed, further evaluation determines whether surgery during gestation is necessary or if delaying surgery until after delivery to minimize fetal and maternal risks is preferred. For patients who have undergone thyroidectomy for thyroid cancer, whether during pregnancy or before it, active management of levothyroxine therapy during pregnancy is recommended to ensure a sufficient thyroid hormone supply for both thyroid cancer treatment and optimal reproductive outcomes. This clinically oriented review summarizes key data, recommendations, and current trends regarding thyroid cancer care in pregnancy.</div></div>","PeriodicalId":21761,"journal":{"name":"Seminars in perinatology","volume":"49 2","pages":"Article 152042"},"PeriodicalIF":3.2,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143610739","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Trends and outcomes associated with cancer diagnoses during delivery hospitalizations
IF 3.2 3区 医学
Seminars in perinatology Pub Date : 2025-03-01 DOI: 10.1016/j.semperi.2025.152046
Timothy Wen , Madeleine G. Fish , Alexander M. Friedman
{"title":"Trends and outcomes associated with cancer diagnoses during delivery hospitalizations","authors":"Timothy Wen ,&nbsp;Madeleine G. Fish ,&nbsp;Alexander M. Friedman","doi":"10.1016/j.semperi.2025.152046","DOIUrl":"10.1016/j.semperi.2025.152046","url":null,"abstract":"<div><div>Pregnancy associated cancer is fortunately rare. However, cancer risk is age related, and the proportion of births to older women in the United States appears to be increasing. As a result of delayed childbearing and better detection, cancer may be increasing in the obstetric population. A review of data from the United States Inpatient Sample found that from 2000 to 2019 the proportion of deliveries with an active cancer diagnosis doubled and deliveries with a diagnosis of a history of cancer more than tripled. These trends and associations are similar to findings from other registries and population-based studies which show that pregnancy associated cancer is increasing and associated with a range of adverse obstetric outcomes including severe maternal morbidity and preterm birth. Given these trends and findings it is likely pregnancy associated cancer will continue to be of public health and clinical importance and represent an ongoing challenge given the maternal and neonatal risks and specialized, coordinated care required to optimize outcomes.</div></div>","PeriodicalId":21761,"journal":{"name":"Seminars in perinatology","volume":"49 2","pages":"Article 152046"},"PeriodicalIF":3.2,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143610743","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Immune checkpoint inhibitors and pregnancy: Considerations for treating medically complex patients with the best available therapy
IF 3.2 3区 医学
Seminars in perinatology Pub Date : 2025-03-01 DOI: 10.1016/j.semperi.2025.152045
Elad Sharon
{"title":"Immune checkpoint inhibitors and pregnancy: Considerations for treating medically complex patients with the best available therapy","authors":"Elad Sharon","doi":"10.1016/j.semperi.2025.152045","DOIUrl":"10.1016/j.semperi.2025.152045","url":null,"abstract":"<div><div>In recent decades, the mean age of childbearing has increased in the United States and other developed countries, coinciding with a rise in cancer diagnoses during pregnancy. This trend is partly due to the increased use of assisted reproductive technologies and a decrease in the mean age of cancer onset for several malignancies. Concurrently, immune checkpoint inhibitors (ICIs) have become a standard treatment for various cancers, yet their safety during pregnancy remains under-researched. This article explores the complex intersection of cancer treatment and pregnancy, focusing on the use of ICIs. Despite societal concerns, data on the safety of ICIs during pregnancy are limited, primarily derived from preclinical animal studies and case reports. While most case reports suggest no significant adverse effects on live births, isolated incidents of severe neonatal complications have been documented. The potential for immune-related adverse events (irAEs) in neonates, such as thyroiditis or enterocolitis, underscores the need for caution. Given the lack of comprehensive data, clinicians face challenging decisions when treating pregnant cancer patients, particularly in metastatic settings where ICIs may be the only viable option. This article advocates for a careful risk-benefit analysis and informed patient discussions, emphasizing the need for further research to guide clinical decision-making in these complex scenarios.</div></div>","PeriodicalId":21761,"journal":{"name":"Seminars in perinatology","volume":"49 2","pages":"Article 152045"},"PeriodicalIF":3.2,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143610742","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Managing pregnancy-associated breast cancer: A practical approach
IF 3.2 3区 医学
Seminars in perinatology Pub Date : 2025-03-01 DOI: 10.1016/j.semperi.2025.152037
Prarthna V. Bhardwaj , Yara Abdou
{"title":"Managing pregnancy-associated breast cancer: A practical approach","authors":"Prarthna V. Bhardwaj ,&nbsp;Yara Abdou","doi":"10.1016/j.semperi.2025.152037","DOIUrl":"10.1016/j.semperi.2025.152037","url":null,"abstract":"<div><div>Pregnancy-Associated Breast Cancer (PABC) is a rare but complex condition that presents both professional and ethical challenges. Diagnosis is often delayed due to breast changes associated with pregnancy and puerperium, which can mask malignant findings. Management requires a multidisciplinary approach that carefully balances maternal and fetal risks.</div><div>Chemotherapy is generally reserved for the second and third trimesters to avoid teratogenicity, with anthracyclines being the most well-studied and safest agents in this setting. Surgical decisions are influenced by factors such as cancer stage, gestational age, and the timing of potential radiation therapy. Notably, radiation therapy, endocrine therapy, and most targeted therapies are contraindicated during pregnancy due to potential harm to the fetus.</div><div>Comprehensive care should include robust social and mental health support for the mother and her family to help navigate the physical and emotional challenges during this period.</div></div>","PeriodicalId":21761,"journal":{"name":"Seminars in perinatology","volume":"49 2","pages":"Article 152037"},"PeriodicalIF":3.2,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143610735","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Ovarian cancer in pregnancy
IF 3.2 3区 医学
Seminars in perinatology Pub Date : 2025-03-01 DOI: 10.1016/j.semperi.2025.152043
Jennifer R. Jorgensen , Molly A. Brewer , Carolyn D. Runowicz
{"title":"Ovarian cancer in pregnancy","authors":"Jennifer R. Jorgensen ,&nbsp;Molly A. Brewer ,&nbsp;Carolyn D. Runowicz","doi":"10.1016/j.semperi.2025.152043","DOIUrl":"10.1016/j.semperi.2025.152043","url":null,"abstract":"<div><div>Objective: The objective of this manuscript is to review the epidemiology, diagnosis, treatment and outcomes of ovarian cancers diagnosed during pregnancy. Finding: Ovarian cancer in pregnancy, although rare, is more likely to be diagnosed early during pregnancy due to the increased use of high resolution ultrasound. Treatment will depend on a multidisciplinary team. These cancers are usually treated with surgery alone during pregnancy, optimally between 13–20 weeks to reduce the risk of miscarriage or preterm labor. Chemotherapy is usually given after delivery if appropriate to the tumor type, unless the patient has widely metastatic disease. Conclusion: The majority of ovarian cancers diagnosed during pregnancy are Stage I due to both young age and increased use of early ultrasound during pregnancy and have a better overall prognosis than the cancers detected in older women.</div></div>","PeriodicalId":21761,"journal":{"name":"Seminars in perinatology","volume":"49 2","pages":"Article 152043"},"PeriodicalIF":3.2,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143610740","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Extending CPAP in stable preterm infants to increase lung growth and development as measured by pulmonary function testing.
IF 3.2 3区 医学
Seminars in perinatology Pub Date : 2025-02-28 DOI: 10.1016/j.semperi.2025.152059
Rachna R Mamidi, Cindy T McEvoy
{"title":"Extending CPAP in stable preterm infants to increase lung growth and development as measured by pulmonary function testing.","authors":"Rachna R Mamidi, Cindy T McEvoy","doi":"10.1016/j.semperi.2025.152059","DOIUrl":"10.1016/j.semperi.2025.152059","url":null,"abstract":"<p><p>Nasal continuous positive airway pressure (CPAP) is the standard of care for the acute management of preterm infants with respiratory distress, however, the optimal duration of CPAP in stable preterm infants is unknown. In utero, preclinical, and clinical data support the premise that mechanical stretch from CPAP can increase lung growth and development. This paper will review data to support this premise, studies examining weaning infants off CPAP, the current practices in the United States regarding CPAP application and duration, and clinical studies of the association of CPAP duration and subsequent lung growth and development. Pulmonary function testing will be presented as an important outcome throughout these trials.</p>","PeriodicalId":21761,"journal":{"name":"Seminars in perinatology","volume":" ","pages":"152059"},"PeriodicalIF":3.2,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143537720","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Update on nasal high frequency oscillatory ventilation: A living review.
IF 3.2 3区 医学
Seminars in perinatology Pub Date : 2025-02-26 DOI: 10.1016/j.semperi.2025.152056
Daniele De Luca, Costanza Neri, Roberta Centorrino
{"title":"Update on nasal high frequency oscillatory ventilation: A living review.","authors":"Daniele De Luca, Costanza Neri, Roberta Centorrino","doi":"10.1016/j.semperi.2025.152056","DOIUrl":"https://doi.org/10.1016/j.semperi.2025.152056","url":null,"abstract":"<p><p>Non-invasive high-frequency oscillatory ventilation (NHFOV) is the main non-conventional ventilatory mode used in newborn infants. NHFOV has been spreading, while knowledge about its physiology, mechanics and clinical application has increased overtime. This is to be considered as a living review, since we here update the knowledge that was originally summarized in a previously published review. We first focus on physiology of such a complex respiratory support technique with practical data on interfaces, patient-ventilator interaction and devices to provide NHFOV. We then move to the evidence-based review of parallel randomized clinical trial published so far. We provide both qualitative and quantitative synthesis of results for the two commonest outcomes, i.e. need for intubation and invasive ventilation and CO<sub>2</sub> elimination. We also provide our protocol to use NHFOV together with other respiratory support modes and we provide suggestions on parameters boundaries and identification of patients to treat. We finally identify still open questions needing future research to optimize the use of NHFOV In preterm infants.</p>","PeriodicalId":21761,"journal":{"name":"Seminars in perinatology","volume":" ","pages":"152056"},"PeriodicalIF":3.2,"publicationDate":"2025-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143515975","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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