SummaryIntroductionCancer complicates approximately 1 in 2000 pregnancies, with increasing incidence due to factors such as increased maternal age, obesity and advancements in antenatal testing. Anaesthetists play a crucial role in managing pregnant patients with cancer, both during delivery and in providing anaesthesia for oncological treatments. This review explores the challenges in anaesthetic management and specific considerations for common cancers encountered in pregnant patients.MethodsAn electronic literature search was carried out using PubMed and Google Scholar to identify peer‐reviewed articles published in English from 1 January 1990 to 30 July 2024.ResultsTwo main areas were identified: anaesthetic management related to pregnancy and the peripartum period in patients with cancer; and oncological management during pregnancy. Current data suggest that pregnancy does not worsen cancer prognosis, but diagnosis and treatment are complicated by the overlap of cancer symptoms with physiological changes of pregnancy and concerns about the safety of diagnostic procedures and treatments. Ultrasound and magnetic resonance imaging are preferred imaging modalities, while careful use of ionising radiation is advised. Treatment during pregnancy, including surgery, chemotherapy and radiotherapy is possible, with specific timing and modality considerations to ensure maternal and fetal safety. Anaemia, poor nutrition and preterm birth are significant concerns in managing pregnant patients with cancer. For operative births, neuraxial techniques are preferred, though general anaesthesia may be required in complex cases. Comprehensive multidisciplinary support, including psychosocial care, is essential for optimal outcomes. Oncological surgery during pregnancy should preferably be scheduled for the second trimester, with consideration for fetal monitoring and steroids. Regional anaesthesia should be utilised if possible and uteroplacental perfusion maintained. Increased risks of thromboembolism should be addressed postoperatively, along with psychological support.DiscussionEffective and safe anaesthetic management of cancer in pregnancy requires a multidisciplinary approach to balance maternal and fetal safety, with a focus on careful planning and individualised care.

中文翻译：

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妊娠期肿瘤疾病的麻醉管理：叙述性回顾


摘要引言癌症并发症化的病例大约每2000例中就有1例，由于产妇年龄增加、肥胖和产前检查的进步等因素，癌症的发病率增加。麻醉师在管理怀孕的癌症患者方面发挥着至关重要的作用，无论是在分娩过程中还是在为肿瘤治疗提供麻醉方面。本综述探讨了麻醉管理的挑战和妊娠患者常见癌症的具体考虑因素。方法使用 PubMed 和 Google Scholar 进行电子文献检索，以确定 1990 年 1 月 1 日至 2024 年 7 月 30 日以英文发表的同行评审文章。以及怀孕期间的肿瘤学管理。目前的数据表明，怀孕不会使癌症预后恶化，但由于癌症症状与怀孕的生理变化重叠，以及对诊断程序和治疗安全性的担忧，诊断和治疗变得复杂。超声和磁共振成像是首选的成像方式，同时建议谨慎使用电离辐射。怀孕期间的治疗，包括手术、化疗和放疗是可能的，但要考虑特定的时间和方式，以确保母体和胎儿的安全。贫血、营养不良和早产是管理怀孕癌症患者的重要问题。对于手术分娩，首选椎管内技术，但在复杂病例中可能需要全身麻醉。全面的多学科支持，包括社会心理护理，对于最佳结局至关重要。 妊娠期的肿瘤手术最好安排在妊娠中期进行，并考虑胎儿监测和类固醇。如果可能，应使用区域麻醉并保持子宫胎盘灌注。术后应解决血栓栓塞风险增加的问题，并提供心理支持。讨论妊娠期癌症的有效和安全麻醉管理需要采用多学科方法来平衡母体和胎儿的安全，重点是仔细的计划和个体化护理。