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LETTERS TO EDITOR
Year : 2022  |  Volume : 66  |  Issue : 4  |  Page : 533  

Unintended pregnancies during cancer therapy requiring pregnancy termination: Can these be avoided?


1 Assistant Professor, Department of Obstetrics and Gynaecology, All India Institute of Medical Sciences, Kalyani, West Bengal, India
2 Associate Professor, Department of Obstetrics and Gynaecology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
3 Professor, Department of Obstetrics and Gynaecology, Postgraduate Institute of Medical Education and Research, Chandigarh, India

Date of Submission12-Jul-2022
Date of Decision29-Aug-2022
Date of Acceptance18-Oct-2022
Date of Web Publication31-Dec-2022

Correspondence Address:
P Sivaranjani
Room No. 501, Type 4 Quarters, All India Institute of Medical Sciences, Kalyani - 741 235, West Bengal
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/ijph.ijph_924_22

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How to cite this article:
Sivaranjani P, Arora A, Suri V. Unintended pregnancies during cancer therapy requiring pregnancy termination: Can these be avoided?. Indian J Public Health 2022;66:533

How to cite this URL:
Sivaranjani P, Arora A, Suri V. Unintended pregnancies during cancer therapy requiring pregnancy termination: Can these be avoided?. Indian J Public Health [serial online] 2022 [cited 2023 Feb 1];66:533. Available from: https://www.ijph.in/text.asp?2022/66/4/533/366594



Dear Editor,

Unintended pregnancies pose an important public health issue. It may lead to a wide range of maternal complications such as septic abortion, anemia, obstetric hemorrhage, malnutrition, and even mortality. In addition, in patients with malignancies, unintended pregnancies can delay cancer therapy, affecting the long-term health of the woman. Cancer associated with pregnancy or delivery is a rare diagnosis with an incidence of 1/1000–2000 pregnancies.[1] It is estimated that approximately 20%–30% of malignancies occur in women younger than 45 years.[1] Improvements in screening methods for malignancies have increased the proportion of fertile women diagnosed with cancer. Thus, there is a growing need for reproductive care for women in the oncology clinic. Reproductive health care in the oncology clinic should include elaborate contraception counseling. This article is to highlight the importance of implementing reproductive health care as a crucial facet of the cancer care continuum in reproductive-aged women.

In our institute over 1 year, 504 medical termination of pregnancy (MTP) was done, of which 9.6% was for maternal indication, 16.26% for unwanted pregnancy, 64.53% for fetal congenital malformations, 2.4% for contraception failure, and 7.2% for sexual assault. About 13.8% (five cases) [Table 1] of maternal indication was a malignancy.
Table 1: Cases with malignancy and unintended pregnancies

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All the abovementioned patients had an interruption in their cancer care continuum, requiring MTP for the ease of cancer therapy. This could have been avoided if reproductive health care would have been a crucial part of the cancer care continuum in reproductive-age women. This reflects the unmet contraceptive needs among the reproductive-age women attending the cancer clinic. The type of cancer indicates the method of contraception in the case of hormone-dependent malignancies, and nonhormonal contraception is recommended as the first-line method.[1] Hence, a multidisciplinary team involving an oncologist, obstetrician, and family planning service provider is a must to intensify the contraception counseling in these reproductive-age females in cancer clinics to avoid unintended pregnancies.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
   References Top

1.
Botha MH, Rajaram S, Karunaratne K. Cancer in pregnancy. Int J Gynaecol Obstet 2018;143 Suppl 2:137-42.  Back to cited text no. 1
    



 
 
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