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Preconception and antenatal care for women with a history of haematopoietic stem cell transplantation: Results of a UK clinician survey

Birchenall, Katherine A; David, Anna L; Davies, Melanie; Grandage, Victoria; Griffin, Melanie; (2024) Preconception and antenatal care for women with a history of haematopoietic stem cell transplantation: Results of a UK clinician survey. Obstetric Medicine 10.1177/1753495X241272942. (In press). Green open access

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Abstract

Background: Female childhood cancer survivors with history of bone marrow transplant with or without total body irradiation have increased pregnancy risks. Preconception counselling and early referral to appropriate clinical pathways may improve pregnancy outcomes. Methods: UK-wide survey of clinicians, promoted via social media and conferences, jointly funded by Action Medical Research/Borne. Results: Forty responses received between 22 October 2020 and 21 October 2021: 43% reviewed this group monthly, 15% annually, 15% less than annually, and 27% never (for O & G only: 13%, 13%, 26%, and 48%, respectively). Pre-pregnancy, most discussed potential fertility/pregnancy implications. Early pregnancy discussions included late miscarriage (34%), preterm birth (44%), fetal growth restriction (31%), and health risks other than cancer (30%). During pregnancy: 80% refer to specialist clinics; 87% offer extra investigations; 33% prescribed aspirin; 20% offered cervical cerclage; and 13% prescribed progesterone. Conclusions: Evidence of variation in care. As previous observations suggest pregnancy outcomes improve when managed in specialist clinics, clearer guidance is required.

Type: Article
Title: Preconception and antenatal care for women with a history of haematopoietic stem cell transplantation: Results of a UK clinician survey
Open access status: An open access version is available from UCL Discovery
DOI: 10.1177/1753495X241272942
Publisher version: http://dx.doi.org/10.1177/1753495x241272942
Language: English
Additional information: This version is the author accepted manuscript. For information on re-use, please refer to the publisher’s terms and conditions.
Keywords: ADOLESCENT, bone marrow transplant, BONE-MARROW-TRANSPLANTATION, CANCER, CHEMOTHERAPY, CHILDHOOD, Childhood cancer survivor, FERTILITY, haematopoietic stem cell transplantation, Life Sciences & Biomedicine, Obstetrics & Gynecology, pregnancy, RADIOTHERAPY, RECOMMENDATIONS, Science & Technology, SURVEILLANCE, total body irradiation, TOTAL-BODY IRRADIATION
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > UCL EGA Institute for Womens Health
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > UCL EGA Institute for Womens Health > Maternal and Fetal Medicine
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > UCL EGA Institute for Womens Health > Reproductive Health
URI: https://discovery.ucl.ac.uk/id/eprint/10199878
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