OBSTETRIC PROBLEMS

Problems during pregnancy

During pregnancy, a baby (and sometimes multiple babies) grows and develops inside the mother’s womb (uterus). In humans, pregnancy takes about 40 weeks, after which the baby is born.

Sometimes problems can occur during pregnancy. These problems include:

  • Miscarriage, when the pregnancy is lost before the baby can survive outside the womb.
  • Low birth weight. Newborn babies that weigh less than expected.
  • Premature birth, when the baby is born between 24 and 37 weeks of pregnancy.

Premature birth and low birth weight can cause health problems in the baby. The severity of the health problems often varies, depending on how early the baby is born and/or how low the birth weight is. Sometimes the baby’s health problems persist, but often premature babies and babies with low birth weight grow up to be healthy children.

Am I at higher risk of problems during pregnancy?

Any woman, including women who have never had cancer treatment, may develop problems during pregnancy. However, there are some cancer treatments that may increase the risk of having problems during pregnancy or delivery later in life.

The following treatments can increase the risk of problems during pregnancy or delivery:

  • Radiotherapy to the womb or an area that includes the womb

You can find out if you have received radiotherapy to the womb by looking at your treatment summary. If you do not have a treatment summary or if you have any questions, do contact your treating hospital.

If you experience problems during pregnancy and delivery, it does not always mean that this is caused by your cancer treatment. Problems during pregnancy and delivery may have other causes.

What are symptoms and signs of late effects?

There are symptoms and signs that can tell you if you might have late effects. You might not have these symptoms and signs at the moment, but it is important to be aware of them in case they may develop in the future.

For each type of late effect, the signs and symptoms are different. If you experience any signs or symptoms of physical or mental health problems, please contact a general practitioner or follow-up care specialist.

I am at higher risk of problems during pregnancy. What tests should I have and when?

If you are at higher risk of problems during pregnancy and delivery, it is advised to have high risk pregnancy surveillance, where extra monitoring and care are given throughout pregnancy and delivery.

You may need extra cardiac surveillance during pregnancy if you were treated with chest irradiation and/or anthracyclines. This includes doing an echocardiogram before the pregnancy and in the first trimester (week 1-12 of the pregnancy). For more information on heart screening during pregnancy and heart problems, please read: Heart problems.

What happens if I have problems during pregnancy?

If you experience or are at risk of problems during pregnancy, your gynaecologist or obstetrician (physician specialised in pregnancy) may discuss different options with you to manage these problems.

What else can I do?

Knowing that you may be at increased risk of problems during pregnancy can be difficult. In addition, experiencing problems during pregnancy can have a big impact on your mental well being. Talking to friends and family can be helpful as well as specialist counselling and/or contact with support groups, such as patient organisations. For more information on taking care of your mental health, please read: Mental health problems.

While pregnant, it is extremely important to live a healthy lifestyle and to be mindful of certain eating / lifestyle habits. This includes, but is not limited to:

  • Not drinking alcohol
  • Avoiding smoking
  • Avoiding raw or undercooked meat, seafood or eggs
  • Avoiding certain types of fish
  • Taking folic acid supplements in the first trimester (week 1-12 of the pregnancy). of your pregnancy

Taking care of your mental health may be beneficial; even small changes to your lifestyle can have a positive impact on both your physical and mental health. For more information on taking up a healthier lifestyle, please read: Health promotion.

You can discuss with your general practitioner or follow-up care specialist whether it is necessary to have a consultation with a specialist before you get pregnant.

It is important that you are aware of the possibility of developing problems during pregnancy. When pregnant, it is important that you receive adequate monitoring. If you have any further questions or if the information in this brochure concerns you, please contact your general practitioner or follow-up care specialist.

Where can I find more information?

You may find more information about pregnancy problems online. However, it is important to be aware that this information is not always up to date or accurate.

Some sources of further information are:

  • NHS: Here you can find more information about pregnancy in general
  • NHS: Here you can find more information about which types of food to avoid during pregnancy
  • NHS: Here you can find more information about the importance of not smoking during pregnancy
  • British Nutrition Foundation: Here you can find more information about a healthy diet during pregnancy
  • Mayo Clinic: Here you can find more information about what a healthy lifestyle during pregnancy entails

On this website, you can also find more information related to this topic:

Please note

This PLAIN summary is based on the PanCareFollowUp guideline about “Obstetric problems” [1], which is itself based on the corresponding IGHG* guideline [2].

While the PanCare PLAIN information group strives to provide accurate and complete information that is up-to-date as of the date of publication, you can check with your general practitioner or follow-up care specialist if this summary reflects the most up-to-date information available and whether it is relevant for you.

Please do not rely solely on this information. It is best to also seek the advice of a qualified medical practitioner if you have questions regarding a specific medical condition, disease, diagnosis or symptom.

No warranty or representation, expressed or implied, is made concerning the accuracy, reliability, completeness, relevance, or timeliness of this information. PanCare has produced the English version and PanCare is not responsible for the translated versions of this summary.

*International Guideline Harmonization Group for Late Effects of Childhood Cancer

[1] van Kalsbeek, R. et al. (2021) European PANCAREFOLLOWUP recommendations for surveillance of late effects of childhood, adolescent, and Young Adult Cancer, European journal of cancer. Available at: https://www.ejcancer.com/article/S0959-8049(21)00368-3/fulltext

[2] Van der Kooi, A.L.F. et al. (2020) Counseling and surveillance of obstetrical risks for female childhood, adolescent, and young adult cancer survivors: recommendations from the International Late Effects of Childhood Cancer Guideline Harmonization Group. Available at: https://www.ajog.org/article/S0002-9378(20)30614-1/fulltext