Monitoring pregnant woman with cancer to deliver a healthy baby

Uvod: Rak predstavlja veliko javnozdravstveno vprašanje, saj je drugi najpogostejši vzrok smrti žensk v reproduktivnih letih. Rak, ki sovpada z nosečnostjo, bo čez leta postal zmeraj pogostejši, saj se zmeraj več žensk odloča za nosečnost v kasnejših letih. Trenutno se rak v času nosečnosti pojavi pri eni na tisoč žensk. Eden od ključnih izzivov pri zdravljenju raka v času nosečnosti je zdravljenje žensk s standardnim režimom, ne da bi pri tem ogrozili plod, ki se še razvija. Rak v nosečnosti zahteva multidisciplinaren pristop, pri katerem sodeluje tudi babica. Namen: Namen diplomskega dela je predstaviti babiško obravnavo ženske z rakom v času nosečnosti, da donosi in rodi zdravega otroka. Metode dela: Uporabljena je bila deskriptivna metoda dela s pregledom domače in tuje literature. V pregled literature smo vključili vire me leti 2008-2020. Literaturo smo iskali s pomočjo podatkovnih baz PubMed, COBIB.SI, CINAHL in ScienceDirect. Rezultati: Za pregled literature smo uporabili 39 virov. Najpogostejše oblike raka, ki se pojavijo pri ženskah z rakom v času nosečnosti, so: rak dojke, rak materničnega vratu ter rak krvi in krvotvornih organov. Postavitev diagnoze raka v času nosečnosti je zahtevna, saj na diagnosticiranje vplivajo fiziološke spremembe. Zaradi ne izpostavljenosti sevanju se za diagnosticiranje najpogosteje uporabita ultrazvok in magnetna resonanca. Najpogostejše tveganje zdravljenja raka v času nosečnosti predstavljata prezgodnji porod in nizka porodna teža ploda. Kemoterapija je v prvem trimesečju kontraindicirana zaradi povečanega tveganja za prirojene nepravilnosti. Babiška obravnava nosečnic z rakom zajema podporo tako nosečnic kot tudi njihovih partnerjev. Razprava in zaključek: Vse pomembnejše bo postalo poznavanje zdravljenja raka v času nosečnosti, zato je pomembno poznati, kakšni so izidi nosečnic z rakom in ploda po zdravljenju raka v nosečnosti. Z združitvijo Registra raka Republike Slovenije in Nacionalnega perinatalnega informacijskega sistema bi morda lahko tudi v Sloveniji pripomogli k boljši sledljivosti ženskam z diagnozo rak.Introduction: Cancer is the second most common cause of death during reproductive years and therefore presents a major public health issue. Cancer that coincide with pregnancy, will become more common over the years, as more and more women decide for pregnancy in later years. Currently, one in a thousand women develop cancer during pregnancy. One of the key challenges in treatment cancer during pregnancy is to treat women with a standard regimen without compromising the development of the fetus. Cancer in pregnancy requires a multidisciplinary approach, including the midwife. Purpose: The purpose of the diploma work is to present the midwifery care of a woman diagnosed with cancer during pregnancy. Methods: A descriptive method of work with a review of domestic and foreign literature was used. The literature review included sources from 2008-2020. The literature was searched using the PubMed, COBIB.SI, CINAHL and ScienceDirect databases. Results: 39 sources were used for the literature review. The most common cancers that occur in woman with cancer during pregnancy are breast cancer, cervical cancer and cancers of blood and blood-forming organ. Diagnosing cancer during pregnancy is challenging because the diagnosis is influenced by physiological changes. Due to the lack of exposure to radiation, ultrasound and magnetic resonance are most commonly used for diagnosis. The most common risks of cancer treatment during pregnancy are preterm birth and low fetal birth weight. Chemotherapy is contraindicated in the first trimester because of the increased risk of congenital anomalies. Midwifery care for pregnant woman with cancer involves supporting both, the pregnant woman and her family. Discussion and conclusion: Knowledge about cancer treatment in pregnancy will become increasingly important, so it is important to know what the outcomes are for pregnant woman with cancer and for the fetus after cancer treatment in pregnancy. By merging the Cancer Registry of the Republic of Slovenia and the National Perinatal Information System, we could contribute to better traceability of woman diagnosed with cancer