CYTOTOXIC THERAPY AND PREGNANCY

The use of cytotoxic agents during pregnancy may be unavoidable in ord er to ensure maternal survival-despite the dangers to the developing f etus. We review 217 such cases published between 1983 and 1995, classi fying them into 5 groups according to whether the cytotoxic drugs were used to treat leukaemias, malignant lymphomas, severe rheumatic disea ses, gynaecological/breast neoplasms, or other grave conditions. Vario us factors, such as the drug type, dose, and timing to exposure to ges tational age, are analysed with respect to the outcome of these pregna ncies (teratogenicity, stillbirths, spontaneous abortions, prematurity , etc,). These results are then integrated in order to determine wheth er one Can predict the individual risk of abnormality for the newborn when cytotoxic agents must be administered to pregnant women faced wit h a malignancy or other serious condition. (C) 1997 Elsevier Science I nc.