1.Knowledge and awareness about fertility preservation among female patients with cancer : a cross-sectional study
Reeta MAHEY ; Shobha KANDPAL ; Monica GUPTA ; Perumal VANAMAIL ; Neerja BHATLA ; Neena MALHOTRA
Obstetrics & Gynecology Science 2020;63(4):480-489
Objective:
The incidence of women in the reproductive age group diagnosed with cancer has recently increased. However, very few patients opt for or are offered fertility preservation (FP) strategies because of a significant lack in awareness. The present study was conducted to evaluate the knowledge of the effect of cancer treatment on fertility and available options for FP.
Methods:
This was a cross-sectional study conducted at a tertiary care center from March 2019 through August 2019. One hundred female patients with gynecological or nongynecological cancer and 18-40 years of age were interviewed. The participants were categorized on the basis of the modified Kuppuswamy socioeconomic status (SES) scale and the responses of the patients in the different categories were compared.
Results:
More than half the patients (63%) were in the 20–35-year age group. Most of the patients (71%) were married, and of them, 28 (39.4%) desired to have children. Only 32% of the patients were aware of the detrimental effect of cancer and its treatment on future fertility, and of them, only 28% could specify the gonadotoxic effect of chemotherapy. Knowledge was significantly higher in the upper and middle SES levels than it was in the lower SES level (P<0.001). More than half of the patients (68%) were not aware of the existing FP options, whereas one-third of the patients (32%) were given information about FP by their physicians.
Conclusion
The overall awareness of the gonadotoxic effect of cancer therapy and available FP options in the present study was poor. Awareness of FP among both patients and clinicians needs to be increased.
2.Knowledge and awareness about fertility preservation among female patients with cancer : a cross-sectional study
Reeta MAHEY ; Shobha KANDPAL ; Monica GUPTA ; Perumal VANAMAIL ; Neerja BHATLA ; Neena MALHOTRA
Obstetrics & Gynecology Science 2020;63(4):480-489
Objective:
The incidence of women in the reproductive age group diagnosed with cancer has recently increased. However, very few patients opt for or are offered fertility preservation (FP) strategies because of a significant lack in awareness. The present study was conducted to evaluate the knowledge of the effect of cancer treatment on fertility and available options for FP.
Methods:
This was a cross-sectional study conducted at a tertiary care center from March 2019 through August 2019. One hundred female patients with gynecological or nongynecological cancer and 18-40 years of age were interviewed. The participants were categorized on the basis of the modified Kuppuswamy socioeconomic status (SES) scale and the responses of the patients in the different categories were compared.
Results:
More than half the patients (63%) were in the 20–35-year age group. Most of the patients (71%) were married, and of them, 28 (39.4%) desired to have children. Only 32% of the patients were aware of the detrimental effect of cancer and its treatment on future fertility, and of them, only 28% could specify the gonadotoxic effect of chemotherapy. Knowledge was significantly higher in the upper and middle SES levels than it was in the lower SES level (P<0.001). More than half of the patients (68%) were not aware of the existing FP options, whereas one-third of the patients (32%) were given information about FP by their physicians.
Conclusion
The overall awareness of the gonadotoxic effect of cancer therapy and available FP options in the present study was poor. Awareness of FP among both patients and clinicians needs to be increased.
3.Fetomaternal outcomes in pregnant women with congenital heart disease: a comparative analysis from an apex institute
Soniya DHIMAN ; Aparna SHARMA ; Akanksha GUPTA ; Richa VATSA ; Juhi BHARTI ; Vidushi KULSHRESTHA ; Satyavir YADAV ; Vatsla DADHWAL ; Neena MALHOTRA
Obstetrics & Gynecology Science 2024;67(2):218-226
Objective:
With advancements in cardiac surgical interventions during infancy and childhood, the incidence of maternal congenital heart disease (CHD) is increasing. This retrospective study compared fetal and cardiac outcomes in women with and without CHD, along with a sub-analysis between cyanotic versus non-cyanotic defects and operated versus non-operated cases.
Methods:
A 10-year data were retrospectively collected from pregnant women with CHD and a 1:1 ratio of pregnant women without any heart disease. Adverse fetal and cardiac outcomes were noted in both groups. Statistical significance was set at P<0.05.
Results:
A total of 86 pregnant women with CHD were studied, with atrial septal defects (29.06%) being the most common. Out of 86 participants, 27 (31.39%) had cyanotic CHD. Around 55% of cases were already operated on for their cardiac defects. Among cardiovascular complications, 5.8% suffered from heart failure, 7.0% had pulmonary arterial hypertension, 8.1% presented in New York Heart Association functional class IV, 9.3% had a need for intensive care unit admission, and one experienced maternal mortality. Adverse fetal outcomes, including operative vaginal delivery, mean duration of hospital stay, fetal growth restriction, preterm birth (<37 weeks), low birth weight (<2,500 g), 5-minute APGAR score <7, and neonatal intensive care unit admissions, were significantly higher in women with CHD than in women without heart disease.
Conclusion
Women with CHD have a higher risk of adverse fetal and cardiac outcomes. The outcome can be improved with proper pre-conceptional optimization of the cardiac condition, good antenatal care, and multidisciplinary team management.