Chemotherapy and pregnancy.

There are still unanswered questions concerning long-term effects of intrauterine exposure to antineoplastics. It is possible that a mechanism of follow-up such as a national registry could be formalized. Although pregnancy in the women with cancer is a rare event, it may occur more frequently in the future. The nurse must be knowledgeable concerning the issues in decision-making and confident in his or her ability to mobilize resources for the patient and family. Overall, the use of cytotoxic agents during the first trimester offers the greatest potential for spontaneous abortion and fetal malformations. In contrast, chemotherapy administered in the second and third trimesters appears to offer minimal risk. What effect this exposure will have on future generations is only speculative. It would be safer if fetal drug exposure could be avoided completely, but when this is not prudent and the mother's life is at stake, careful consideration and thoughtful guidance is appropriate for the pregnant patient with cancer.