Cancer chemotherapy during pregnancy - Consortium of cancer in pregnancy evidence

QUESTION I have an 8-weeks' pregnant patient who was diagnosed with stage I II Hodgkin's disease last week. The oncologist suggests delaying chemothera py until the second trimester. What are the effects of chemotherapy on a fe tus after the first trimester? Where can I find reliable information on the subject? ANSWER Available data suggest that exposure to chemotherapy during the firs t trimester of pregnancy is associated with increased risk of major malform ations. Exposure during the second and third trimesters does not result in major malformations, but could have nonteratogenic effects, such as low bir th weight. The brain develops throughout pregnancy, and it could be affecte d later in pregnancy.