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The incidence of malignant tumors have a dramatic increase in the past 30 years, has become one of the world's leading cause of death for women of childbearing. In the past decades, the malignancy has become a major public health problem in China. According to China's recent health reports, cancer has become the second largest cause of death of the Chinese women, has become an important cause of death in women of childbearing age. The incidence of malignant tumors during pregnancy reports vary, approximately 1/1000 to 1/6000 of pregnancy. Most pregnant women with malignant tumors are the predilection of malignant tumors of the reproductive age, such as: breast cancer, cervical cancer, Hodgkin's disease, malignant melanoma and leukemia and other. A variety of tumor incidence is getting younger, with the change of the tremendous development of the economy and the traditional concept of Chinese women of childbearing age in the age of marriage and childbearing tend to be more mature, especially in southern China. Therefore, it is reasonable to speculate that malignant tumors may become an important pregnancy complications in future decades. Tremendous physiological changes of pregnancy for malignant tumors may have some impact: pregnancy special physiological changes may mask the tumor condition caused by the tumor misdiagnosis and delay tumor treatment; pregnancy with the promotion of certain malignancies role in its development; of pregnancy pelvic blood flow and lymphatic drainage for the growth of malignant cells to create favorable conditions, but there are no results confirmed pregnancy will accelerate the growth of tumor cells, planting and disseminated. Malignancy has an important impact on pregnancy as: the tumor directly affect the pregnancy and delivery: the impact of some of the clinical symptoms of the tumor eating, increased tumor consumption of pregnant women found that mental stress after tumor exacerbate staff may result in malnutrition of pregnant women, thus affecting the development of the fetus in utero, severe induced abortion pregnancy, premature birth, fetal growth restriction, low birth weight children, the increase in the incidence of low birth weight children, perinatal child mortality; surgical treatment of tumor-induced abortion, premature birth; period of chemotherapy can cause fetal malformations, fetal growth retardation and miscarriage; radiation therapy may induce leukemia and tumors of children and adults in the future. Although the treatment of pregnant women with malignant tumors have gradually accumulated in the past decade, but has yet to form a definitive treatment plan, treatment during pregnancy are still many questions, such as the termination of pregnancy is necessary; pregnancy will to speed up the progress of the tumor; extension treatment affects maternal prognosis. Complications of pregnancy associated with ovarian malignancy, pregnancy whether to continue, the choice of the mode of delivery, and the prognosis of patients is a hot research. At home and abroad about the treatment of gestational malignancies reported in the literature more case reports mainly to the lack of a large sample survey. The purpose in view of the doubts and uncertainties on the treatment of pregnant women with malignant tumors, this study by the clinical data from three large teaching hospital in Guangzhou and Shenzhen in nearly 16 years diagnosed during pregnancy in patients with malignant tumor Retrospective analysis, analysis of its characteristics, treatment and outcome, and analysis of interactions that may occur between the disease and pregnancy. Analysis of these raw data, in order to put forward the exact information, so as to provide clinical evidence to find the best treatment options for gestational malignancy. Retrospective analysis methods, data collection methods, collect Southern Medical and Great Southern Hospital, the First People's Hospital of Shenzhen and Peking University Shenzhen Hospital three tertiary hospitals from January 1992 to December 2008, admitted in pregnancy is diagnosed for the merger of the 34 cases of malignant cases. Before pregnancy has been treated, or the end of treatment were excluded, the malignancy is not be excluded at this stage diagnosis and DCIS. A random sample of 100 cases over the same period in the hospital giving birth normal maternal pregnancy complications (Nanfang Hospital, 40 cases, 30 cases of the Shenzhen People's Hospital, Peking University Shenzhen Hospital, 30 cases) as the control group. History information including age, pregnancy history, found that symptoms of gestational age, gestational age at diagnosis, the pathological type of tumor staging, the treatment of pregnancy, mode of delivery, postpartum hemorrhage, puerperal morbidity occurrence, birth weight born ratings, post-natal treatment by the retrospective collection of case investigations, follow-up of patients and offspring obtained by telephone follow-up questionnaire. Second, the diagnostic criteria for patients with gestational age and gestational age by the obstetrician Wenzhen of the last menstrual period, physical examination and ultrasound examination to determine the entire pregnancy obstetric situation by the seniority of the obstetrician custody. The diagnosis and staging of all patients with malignant tumors of the class of tumor staging according to the International Union Against Cancer released by specialist physicians stage at diagnosis, the pathological diagnosis on two high qualification pathologist consultation. Patients progeny include assessment of fetal and neonatal both obstetricians and pediatricians together to complete. Method 1, the collection and analysis of cases of pregnant women with cancer patients to understand the incidence of this relatively rare pregnancy complications in pregnant women with malignancies, malignant type of distribution. 2, in order to get the mutual influence on malignant tumors and pregnancy, malignancy in this study will be considered as a whole, patients were divided into two groups according to whether the termination of pregnancy during pregnancy pregnancy with malignancy: termination of pregnancy group and continue pregnancy group. Comparative analysis to the diagnosis of malignant tumors and survival rates between two groups of pregnancy symptoms occur. 3, random sample of 100 cases (Nanfang Hospital, 40 cases, 30 cases of the Shenzhen People's Hospital, Peking University Shenzhen Hospital, 30 cases) over the same period as a control group of normal maternal hospital childbirth pregnancy complications. Pregnant women with malignant tumors continue the pregnancy and control groups on a comparative analysis of the mode of delivery, postpartum hemorrhage, the incidence of puerperal morbidity, prevalence of neonatal, neonatal weight. The statistical processing applications statistics software SPSS 13.0 statistical analysis, tabulation and drawing in Excel in 2003, P <0.05, said the difference was statistically significant; measurement data described using the mean and standard deviation, normal conditions are satisfied groups were compared using two independent samples t-test, does not meet the normality by using the Mann-Whitney test; frequency data described using% said, using the chi-square test (or continuity correction chi-square test); survival analysis data of the two groups The median time Log-Rank test was used to compare. Results of a detection rate of pregnant women with malignant tumors and malignant type distribution. Pregnant women with malignancies of hospital detection rate of 0.682 ‰, per 1000 deliveries 0.682 cases. Reproductive system cancers in 12 cases, accounting for 35.3% (7 cases of cervical cancer, ovarian cancer, 5 patients). 22 cases of non-reproductive system cancers, accounting for 64.7% (breast cancer, leukemia four cases, three cases of nasopharyngeal carcinoma, three cases of liver cancer, non-Hodgkin's lymphoma, brain stem glioblastoma, giant cell tumor mucinous adenocarcinoma of the rectum, spinal glioma, melanoma, lung cancer, squamous carcinoma of the maxillofacial each cases). 34 cases the diagnosis and pregnancy treatment 1,6 cases were diagnosed during early pregnancy (before 13 weeks), accounting for 17.65%; 15 cases were diagnosed in mid-pregnancy (14-27 weekend), accounting for 44.12%; 8 cases were diagnosed during late pregnancy (after 28 weeks), accounting for 23.53%; five cases in the intrapartum and post-natal diagnosis, accounting for 14.70%. The time of the onset of symptoms to diagnosis was 2.32 ± 2.86 weeks gestational age was 29.06 ± 10.56 weeks of termination of pregnancy, the time of onset to termination of pregnancy was 9.46 ± 7.94 weeks. 2,34 cases, nine patients in the surgical treatment of the tumor during pregnancy, chemotherapy, six cases radiotherapy patients during pregnancy. 3,16 cases of termination of a pregnancy, 18 patients chose to continue the pregnancy. Three pregnant women with cancer to continue the pregnancy group and to terminate the pregnancy group, pregnant women with malignant continue the pregnancy group average age 31.50 ± 5.52 years, pregnancies, 1.89 ± 0.90, parity and 0.67 ± 0.77, the onset of gestational age 26.09 ± 8.51 weeks diagnosis of gestational age 30.43 ± 8.18 weeks, the incidence of the diagnosis time weeks 3.48 ± 3.66, 35.87 ± 2.78 weeks to terminate the pregnancy, gestational age, maternal survival time was 22.87 ± 34.96 months. Termination of pregnancy with malignancies the pregnancy mean age 30.06 ± 5.37 years old, the gravidity 2.25 ± 1.00, parity 0.81 ± 0.75 incidence of gestational age 18.57 ± 10.25 weeks gestational age 19.73 ± 10.22 weeks of diagnosis, the incidence of 18.57 ± 10.25 weeks to the time of diagnosis termination of pregnancy gestational age 21.41 ± 10.89 weeks the maternal survival time was 29.00 ± 34.83 months. Between the two groups of age (t = 0.767, P = 0.449), progesterone (t = -1.108, P = 0.276), parity (Z = -0.616, P = 0.538), maternal survival time (Z = -1.123, P = 0.261) showed no significant difference (P> 0.05); between the two groups incidence gestational age (t = 2.260, P = 0.031), diagnosis of gestational age (t = 3.387, P = 0.002), onset to time of diagnosis (Z = -2.916, P = 0.004), termination of pregnancy gestational age (Z = -4.125, P = 0.000), a significant difference (P <0.05). 2, pregnant women with cancer to continue the pregnancy group of five-year survival rate: 38.89%, the median survival time was 10 months; terminate the pregnancy group of five-year survival rate of 43.75%, the median survival time was 24 months. Two sets of survival time depict survival curves, Log-Rank test was used to compare the median survival time: x to 2 = 0.596, P = 0.440, no significant difference between two groups of survival time. 3, pregnant women with malignant tumors continue the pregnancy group onset to the time of termination of pregnancy and maternal survival time doing Spearman correlation analysis results: r = 0.454, P = 0.078, no statistical significance. Pregnancy with malignant continue the pregnancy and normal pregnancy control group 1, pregnant women with malignant tumors continue the pregnancy group average age 31.50 ± 5.52 years, pregnancies, 1.89 ± 0.90, 0.67 ± 0.77 parity; 30.25 ± 5.41 of the average age of the control group years, mean gravidity 2.25 ± 1.00, the average production time 0.81 ± 0.75. Between the two groups of pregnant (t = 0.094, P = 0.926), parity (t = -1.403, P = 0.175) showed no significant difference, but a significant difference in age (t = -2.762, P = 0.007) significant difference (P <0.05). 2, pregnant women with malignant group to terminate the pregnancy, gestational age 35.87 ± 2.78 weeks; 15 cases of cesarean section, cesarean section rate was 83.3%; postpartum hemorrhage in seven cases, the rate was 38.9%; puerperal morbidity occurred four cases, the incidence of 22.2%; control group to terminate the pregnancy, gestational age of 38.70 ± 1.39 weeks, 27 cases of cesarean section, 27.0% of the cesarean section rate, postpartum bleeding in 4 patients, the incidence of 4%; puerperal morbidity occurred four cases, the occurrence rate 4%. Termination of pregnancy gestational age between the two groups (t = 4.233, P = 0.000), the rate of cesarean section (x ~~ 2 = 21.117, P = 0.000), the rate of postpartum hemorrhage (x ~ 2 = 21.966, P = 0.000), production mattress disease rate (x ~ 2 = 8.014, P = 0.005), there were significant differences (P <0.05). 3, pregnant women with cancer to continue the pregnancy group birth weight 2661.11 ± 648.05g, premature birth 10 cases, 55.6% of the incidence of low birth weight children 4 cases, 22.2% of the incidence of neonatal asphyxia three cases are mild asphyxia, newborn children asphyxia rate of 16.7%; neonatal body weight of normal pregnancy group 3242.55 ± 449.60g, premature birth seven cases, the incidence of 7%, 7% of the 7 cases of low birth weight infants, the incidence of neonatal asphyxia three cases are mild asphyxia, newborn children asphyxia rate of 7%. The incidence of preterm newborn weight between the two groups (t = 4.694, P = 0.000), (x ~ 2 = 29.165, P = 0.000), the incidence of low birth weight infants (x ~ 2 = 4.182, P = 0.041), and newborn the asphyxia (x ~ 2 = 5.904, P = 0.015) showed a significant difference (P <0.05). Conclusion 1, pregnant women with malignant tumors are not uncommon, and reproductive system cancer, cervical and ovarian cancer is more common, non-reproductive system cancer, breast cancer, leukemia, nasopharyngeal cancer, liver cancer more common. Maternal cesarean section rate in pregnant women with cancer, the incidence of preterm birth, postpartum hemorrhage, and puerperal morbidity incidence was significantly higher. 3, pregnant women with malignant tumors in patients with neonatal significantly lower body weight, premature children, the incidence of low birth weight infants and neonatal asphyxia was significantly higher. 4, pregnant women with cancer mortality is high when the follow-up to 30 months, 60% of the patients died, but the termination of pregnancy during pregnancy does not prolong the survival time of patients. 5, this group the pregnancy combined incidence of malignant tumors to termination of pregnancy with maternal survival time was no significant correlation. In summary, pregnant women with low incidence of malignant tumors, the survival rate is low, a greater impact on the mother-to-child, termination of pregnancy does not prolong survival time. Pregnancy treatment of pregnant women with malignant tumors according to tumor stage should follow tumor treatment principles on the basis of pregnancy, gestational age, patients with the willingness to develop a personalized program.
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