Effects of cisplatin administration during pregnancy

Cisplatin administration during pregnancy may pose risk to the child including congenital malformations and thus the foetus must be checked throughout chemotherapeutic administration. This systematic review was conducted using PubMed where clinical and pre-clinical articles were found. This study aims to understand the risks cisplatin poses to the mother and the unborn child. Many pregnant patients identified in this study were treated for gynecological malignancies (51, 76.1 % out of 67 patients) and were administered cisplatin-based therapy during the 2nd trimester (14 of 67 patients, 20.8 %). Unmodified treatments were administered in 57 (85.0 %) out of 67 patients. However, 10 (14.9 %) out of 67 patients received modified treatments as unmodified treatments was not a possible treatment option. Modifications to treatments may include reducing the interval between treatments to allow a longer period to recover from the cytotoxic effects of cisplatin. Of these 67 patients receiving cisplatin-based therapies administered in pregnancy 13 children reported complications as a neonate or during early childhood. Overall, the general health of the neonates was positive with majority reporting no abnormalities. However, a higher proportion of neonates (13 of 67, 19.4 %) displayed complications after intrauterine exposure to cisplatin-based therapies than in a control cohort, in which abnormalities were recorded in 4 % of newborns. Neonates of cisplatintreated mothers presented with different complications, the most common of which was respiratory distress observed in 5 of 13 (38.4 %) neonates. Other complications were only recorded in one neonate and included bilateral hearing loss, growth restrictions, or death. It is still unknown whether these abnormalities are primarily caused by intrauterine cisplatin exposure, premature delivery, or a combination of both. Overall, our results support the European Society for Medical Oncology’s guidelines for chemotherapy administration during pregnancy.