Obstetric problems

What are pregnancy-related problems?

During pregnancy, a baby (sometimes more than one baby) grows and develops in a woman’s womb (uterus). In humans, a pregnancy lasts about 40 weeks.

Sometimes pregnancy-related problems occur, such as:

• Miscarriage: the pregnancy ends before the baby is viable

• Low birth weight: the baby weighs too little at birth

• Preterm birth: the baby is born between 24 and 37 weeks of pregnancy

Low birth weight and preterm birth can cause health problems for the baby. Most babies with low birth weight and most babies born prematurely grow up to be healthy children, but some children may have long-term problems.

Do I have an increased risk of pregnancy-related problems?

Every woman, including women who have never had cancer, can experience pregnancy-related problems. However, some cancer treatments can increase the risk.

The following treatment can increase the risk of pregnancy-related problems:

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

You can check the summary of your treatment to see whether you received this treatment. If you do not have a treatment summary, you can contact the LATER clinic or the hospital where you were treated.

Pregnancy-related problems are not always caused by cancer treatment. There may also be other causes.

What are symptoms and signs of possible future pregnancy-related problems?

There are symptoms and signs that may indicate possible future pregnancy-related problems. Even if you do not have these symptoms or signs at the moment, it is important to recognise them in case you experience them in the future.

It is possible that you will need extra heart monitoring during pregnancy if you were treated with radiotherapy to the chest and/or anthracyclines. See also: Heart problems.

If you recognise symptoms or signs in yourself, contact your general practitioner or LATER doctor.

I have an increased risk of pregnancy-related problems. What tests are needed and when?

If you have an increased risk of pregnancy-related problems, the advice is to:

• Receive additional monitoring and support during pregnancy and childbirth

If you have an increased risk of heart problems due to radiotherapy to the chest and/or anthracyclines:

• You will have an echocardiogram before pregnancy and during the first three months of pregnancy

What happens if I have pregnancy-related problems?

If you are at risk of pregnancy-related problems, your midwife or gynaecologist will discuss with you how best to monitor and support you during pregnancy and childbirth.

What else can I do?

It can be difficult to know that you have an increased risk of pregnancy-related problems. Talking to friends and family can help. Contact with people in a similar situation can also be helpful, for example through a patient organisation such as VOX, which is part of the Dutch Childhood Cancer Parent Organisation.

You can ask your general practitioner or LATER doctor whether it is necessary to see a specialist before becoming pregnant.

Take good care of yourself and your unborn child when you want to become pregnant or are already pregnant:

• Do not drink alcohol

• Avoid (passive) smoking

• Do not eat raw or undercooked meat, shellfish, or eggs

• Avoid certain types of fish

• Take folic acid during the first three months of pregnancy

Also take care of your mental health. Small changes can already have a positive effect on your physical and mental well-being. Read more about choosing a healthy lifestyle and paying attention to your mental health.

It is important that you are aware of the possibility of pregnancy-related problems and that you receive appropriate guidance. If you have questions or if you are worried after reading this information, contact your general practitioner or LATER doctor.

Where can I find more information?

This LATER website also provides information about:

• Healthy lifestyle

• Heart problems

• Mental health

• High blood pressure

The PanCare Plain Language Summaries contain links to reliable information in English. You can also search online for information, but keep in mind that it is not always up to date or accurate.

Disclaimer

This information is based on the lay summary of the guideline developed by the PanCare Plain Information Group and has been adapted where necessary to the Dutch LATER guideline. Do not rely solely on this information if you have symptoms or signs, but contact your general practitioner, LATER doctor, or specialist.