OBJECTIVE: Primary bone and soft-tissue tumors occur rarely in pregnancy. T he objective of this study was to describe the outcome of a large cohort of pregna nt patients with these rare tumors. METHODS: Pregnant wome...OBJECTIVE: Primary bone and soft-tissue tumors occur rarely in pregnancy. T he objective of this study was to describe the outcome of a large cohort of pregna nt patients with these rare tumors. METHODS: Pregnant women diagnosed with bone or soft-tissue tumors during pregnancy or within 3 months after delivery were i dentified retrospectively for the years 1983-2003 in the University Health Netw ork database, University of Toronto. Relevant maternal and neonatal data were co llected on a standardized data form. RESULTS: In more than 60,000 deliveries dur ing the study period, 17 patients were identified. Gestational age at diagnosis ranged from 11 weeks to 2 months postpartum. Eight cases involved the lower extr emity and 6 involved the upper extremity. Osteosarcoma, chondrosarcoma, and gian t-cell tumors were the most common histological types. Metastases occurred in 7 cases. Nine cases were treated surgically during the course of pregnancy. The m ajority of patients were delivered at term. Chemotherapy was deferred until the postpartum period. One patient elected for early termination of pregnancy. Three patients were delivered before 37 weeks of gestation to proceed with therapy. O ne neonate delivered at 34 weeks developed respiratory distress syndrome and req uired intubation. Three patients died, all as the result of metastatic disease. There were no perinatal or infant deaths. CONCLUSION: Most cases of soft-tissue and bone tumors during pregnancy can be successfully managed with surgery durin g gestation. Therapies with fetal toxicity were more likely to be deferred to th e postpartum period.展开更多
Objectives: To examine whether admission hospital type (13 perinatal centers v s 4 freestanding pediatric hospitals) was associated with differences in risk an d illness severity adjusted mortality and morbidity among...Objectives: To examine whether admission hospital type (13 perinatal centers v s 4 freestanding pediatric hospitals) was associated with differences in risk an d illness severity adjusted mortality and morbidity among outborn preterm infant s. Study design: Records of singleton outborn infants ≤32 weeks’gestational ag e (n = 605) admitted to 17 tertiary level neonatal intensive care units particip ating in the Canadian Neonatal Network for the period 1996 to 1997 were examined . Results: Outborn infants admitted to freestanding pediatric hospitals were at higher risk of death (adjusted odds ratio [AOR], 2.25; 95%confidence interval [ CI], 1.20, 4.20), nosocomial infection (AOR, 2.48; 95%CI, 1.64, 3.73), and oxyg en dependency at 28 days of age (AOR, 1.77; 95%CI, 1.14, 2.75) when compared wi th outborn infants admitted to perinatal centers. Conclusions: After adjustment for perinatal risks and admission illness severity, outborn infants had better o utcomes if they were admitted to perinatal centers compared with freestanding pe diatric hospitals.展开更多
文摘OBJECTIVE: Primary bone and soft-tissue tumors occur rarely in pregnancy. T he objective of this study was to describe the outcome of a large cohort of pregna nt patients with these rare tumors. METHODS: Pregnant women diagnosed with bone or soft-tissue tumors during pregnancy or within 3 months after delivery were i dentified retrospectively for the years 1983-2003 in the University Health Netw ork database, University of Toronto. Relevant maternal and neonatal data were co llected on a standardized data form. RESULTS: In more than 60,000 deliveries dur ing the study period, 17 patients were identified. Gestational age at diagnosis ranged from 11 weeks to 2 months postpartum. Eight cases involved the lower extr emity and 6 involved the upper extremity. Osteosarcoma, chondrosarcoma, and gian t-cell tumors were the most common histological types. Metastases occurred in 7 cases. Nine cases were treated surgically during the course of pregnancy. The m ajority of patients were delivered at term. Chemotherapy was deferred until the postpartum period. One patient elected for early termination of pregnancy. Three patients were delivered before 37 weeks of gestation to proceed with therapy. O ne neonate delivered at 34 weeks developed respiratory distress syndrome and req uired intubation. Three patients died, all as the result of metastatic disease. There were no perinatal or infant deaths. CONCLUSION: Most cases of soft-tissue and bone tumors during pregnancy can be successfully managed with surgery durin g gestation. Therapies with fetal toxicity were more likely to be deferred to th e postpartum period.
文摘Objectives: To examine whether admission hospital type (13 perinatal centers v s 4 freestanding pediatric hospitals) was associated with differences in risk an d illness severity adjusted mortality and morbidity among outborn preterm infant s. Study design: Records of singleton outborn infants ≤32 weeks’gestational ag e (n = 605) admitted to 17 tertiary level neonatal intensive care units particip ating in the Canadian Neonatal Network for the period 1996 to 1997 were examined . Results: Outborn infants admitted to freestanding pediatric hospitals were at higher risk of death (adjusted odds ratio [AOR], 2.25; 95%confidence interval [ CI], 1.20, 4.20), nosocomial infection (AOR, 2.48; 95%CI, 1.64, 3.73), and oxyg en dependency at 28 days of age (AOR, 1.77; 95%CI, 1.14, 2.75) when compared wi th outborn infants admitted to perinatal centers. Conclusions: After adjustment for perinatal risks and admission illness severity, outborn infants had better o utcomes if they were admitted to perinatal centers compared with freestanding pe diatric hospitals.
