Cancer Chemotherapy and Pregnancy

Abstract Objective To promote careful education, administration, monitoring and restricted distribution when prescribing and dispensing chemotherapeutic and potentially teratogenic medications, as well as to develop clinical recommendations for the use of cancer chemotherapy in pregnant women and women of child-bearing age. Outcomes To ensure that women of child-bearing age receiving chemotherapy can be appropriately counselled on the risks of becoming pregnant during treatment, and to provide guidance for health care practitioners treating pregnant women with antineoplastic agents. Evidence Published literature was retrieved through searches of PubMed or Medline, CINAHL, and The Cochrane Library in 2011, using appropriate controlled vocabulary (e g, antineoplastic agents, neoplasms, pregnancy) and key words (e g, cancer, neoplasms, pregnancy, chemotherapy, antineoplastic agents) Results were restricted to systematic reviews, randomized control trials/controlled clinical trials, and observational studies Studies were restricted to those with available English abstracts or text. Searches were updated on a regular basis and incorporated in the guideline to October 2011. Grey (unpublished) literature was identified through searching the websites of health technology assessment and health technology assessment-related agencies, clinical practice guideline collections, clinical trial registries, and from national and international medical specialty societies. Values The quality of evidence is rated using the criteria described in the Report of the Canadian Task Force on Preventive Health Care (Table 1). Benefits, harms, and costs This guideline highlights the need to prevent pregnancy in women who are being treated for cancer and informs health care professionals treating pregnant women with chemotherapy of the potential risks of the therapy or ameliorated treatment protocols.