Obstetric and Gynecologic Emergencies in Cancer Patients

  • Matthew P. SchlumbrechtEmail author
  • Diane C. Bodurka
Part of the MD Anderson Cancer Care Series book series (MDCCS)


Gynecologic emergencies in cancer patients can be significant, and knowledge of the approach to treatment of these emergencies is crucial to optimizing the patient’s oncologic and gynecologic care. This chapter outlines the basic principles of diagnosis and treatment of obstetric and gynecologic emergencies in cancer patients.


Pregnancy Chemotherapy Radiation Infection Ectopic Fistula Hemorrhage 

Suggested Readings

  1. American College of Obstetricians and Gynecologists. Committee Opinion Number 299: Guidelines for diagnostic imaging during pregnancy. 2004.Google Scholar
  2. American College of Obstetricians and Gynecologists. Practice Bulletin Number 82: Management of herpes in pregnancy. 2007.Google Scholar
  3. American College of Obstetricians and Gynecologists. Practice Bulletin Number 94: Medical management of ectopic pregnancy. 2008.Google Scholar
  4. Azim HA, Pavlidis N, Peccatori FA. Treatment of the pregnant mother with cancer: a systematic review on the use of cytotoxic, endocrine, targeted agents and immunotherapy during pregnancy. Part II: hematologic tumors. Cancer Treat Rev. 2010a;36:110–21.CrossRefPubMedGoogle Scholar
  5. Azim HA, Peccatori FA, Pavlidis N. Treatment of the pregnant mother with cancer: a systematic review on the use of cytotoxic, endocrine, targeted agents and immunotherapy during pregnancy. Part I: solid tumors. Cancer Treat Rev. 2010b;36:101–9.CrossRefPubMedGoogle Scholar
  6. Bahadursingh AM, Longo WE. Colovaginal fistulas. Etiology and management. J Reprod Med. 2003;48:489–95.PubMedGoogle Scholar
  7. Barber HRK. Fetal and neonatal effects of cytotoxic agents. Obstet Gynecol. 1981;58:41–7.Google Scholar
  8. Barnhart KT, Gosman G, Ashby R, Sammel MD. The medical management of ectopic pregnancy: a meta-analysis comparing “single dose” and “multidose” regimens. Obstet Gynecol. 2003;101:778–84.CrossRefPubMedGoogle Scholar
  9. Bodurka DC, Burke T. Obstetric and gynecologic emergencies. In: Yeung S, Escalante C, editors. Oncologic emergencies. Hamilton, ON: BC Decker; 2002. p. 433–40.Google Scholar
  10. Bouyer J, Coste J, Shojael T, et al. Risk factors for ectopic pregnancy: a comprehensive analysis based on a large case-control, population-based study in France. Am J Epidemiol. 2003;157:185–94.CrossRefPubMedGoogle Scholar
  11. Centers for Disease Control and Prevention, Workowski KA, Berman SM. Sexually transmitted diseases treatment guidelines, 2006. MMWR Recomm Rep. 2006;55:1–94.Google Scholar
  12. Centers for Disease Control and Prevention. Sexually transmitted diseases. Published 2006. Accessed 3 May 2010.
  13. Centers for Disease Control and Prevention. Update to CDC’s sexually transmitted diseases treatment guidelines, 2006: Fluoroquinolones no longer recommended for treatment of gonococcal infections. MMWR Morb Mortal Wkly Rep. 2007;56:332–6.Google Scholar
  14. Hall EJ, Giaccia AJ. Effects of radiation on the embryo and fetus. In: Hall E, editor. Radiobiology for the radiologist. 4th ed. Philadelphia, PA: J.B. Lippincott Williams & Wilkins; 1994.Google Scholar
  15. Jemal A, Siegel R, Ward E, Hao Y, Xu J, Thun MJ. Cancer statistics, 2009. CA Cancer J Clin. 2009;59:225–49.CrossRefPubMedGoogle Scholar
  16. Luis SA, Christie DRH, Kaminski A, Kenny L, Peres MH. Pregnancy and radiotherapy: management options for minimising risk, case series and comprehensive literature review. J Med Imaging Radiat Oncol. 2009;53:559–68.CrossRefPubMedGoogle Scholar
  17. Lyss SB, Kamb ML, Peterman TA, et al. Chlamydia trachomatis among patients infection with and treated for Neisseria gonnorrhoeae in sexually transmitted disease clinics in the United States. Ann Intern Med. 2003;139:178–85.CrossRefPubMedGoogle Scholar
  18. McCormack W. Current concepts in pelvic inflammatory disease. N Engl J Med. 1994;330:115–9.CrossRefPubMedGoogle Scholar
  19. Miller EA, Webster GD. Current management of vesicovaginal fistulae. Curr Opin Urol. 2001;11:417–21.CrossRefPubMedGoogle Scholar
  20. Mir O, Berveiller P, Ropert S, Goffinet F, Goldwasser F. Use of platinum derivatives during pregnancy. Cancer. 2008a;113:3069–74.CrossRefPubMedGoogle Scholar
  21. Mir O, Berveiller P, Ropert S, et al. Emerging therapeutic options for breast cancer chemotherapy during pregnancy. Ann Oncol. 2008b;19:607–13.CrossRefPubMedGoogle Scholar
  22. Oltmann SC, Fischer A, Barber R, Huang R, Hicks B, Garcia N. Cannot exclude torsion—a 15-year review. J Pediatr Surg. 2009;44:1212–6.CrossRefPubMedGoogle Scholar
  23. Stovall M, Blackwell CR, Cundiff J, et al. Fetal dose from radiotherapy with photon beams: report of AAPM Radiation Therapy Committee Task Group No. 36. Med Phys. 1995;22:63–82.CrossRefPubMedGoogle Scholar
  24. Varras M, Tsikini A, Polyzos D, Samara C, Hadjopoulos G, Akrivis C. Uterine adnexal torsion: pathologic and gray-scale ultrasonographic findings. Clin Exp Obstet Gynecol. 2004;31:34–8.PubMedGoogle Scholar
  25. Xu F, Sternberg MR, Kottiri BJ, et al. Trends in herpes simple virus type 1 and type 2 seroprevalence in the United States. JAMA. 2006;8:964–73.CrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media New York 2016

Authors and Affiliations

  1. 1.Banner MD Anderson Cancer CenterGilbertUSA
  2. 2.Department of Gynecologic Oncology and Reproductive MedicineThe University of Texas MD Anderson Cancer CenterHoustonUSA

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