Pregnancy and maternal outcomes in women with prior or current gastrointestinal malignancies.

OBJECTIVES: To review the fetal and maternal outcomes of women with a diagnosis of gastrointestinal (GI) cancer before or during pregnancy.

METHODS: We conducted a retrospective cohort study of pregnant women referred to a single tertiary care centre with a current or previous diagnosis of GI malignancy. Maternal, obstetric, and infant data were recorded.

RESULTS: We identified 18 pregnancies in 13 women. Nine women were found to have a GI malignancy during pregnancy (group 1). There was an indirect maternal death in this group in a woman with advanced gastric adenocarcinoma. Nine unique pregnancies occurred in eight women with diagnosis and management of GI malignancies before their pregnancies (group 2).

CONCLUSION: GI malignancies are difficult to diagnose and manage during pregnancy and are usually advanced at the time of diagnosis. Surgery can be performed during pregnancy if necessary, with chemotherapy and radiotherapy usually deferred to the postpartum period. Women who have had a prior GI malignancy have special circumstances related to the type of surgery performed and previous exposure to chemotherapy. These patients may benefit from a multidisciplinary team effort to optimize their care.