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Cancer Chemotherapy Exposure in Pregnancy — General Principles
A 27-year-old at 18 weeks with Hodgkin lymphoma requires chemotherapy. Outline maternal–fetal considerations in oncologic therapy.
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Neonatal monitoring: CBC at birth, long-term follow-up for growth/development
Greatest teratogenic risk is in 1st trimester; 2nd/3rd trimester use of selected agents safer
Supportive care: G-CSF as needed, transfusions, infection prophylaxis; avoid teratogenic adjuncts (e.g., ACE inhibitors for TLS)
Anthracyclines, vinca alkaloids, cyclophosphamide are used; avoid methotrexate, cytarabine high-dose, and targeted biologics
Avoid chemotherapy within 3 weeks of delivery to reduce neonatal cytopenia; plan timing with oncology team
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