Management of Hodgkin' Disease Coexistent with Pregnancy

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Abstract
Review of the literature indicates that Hodgkin''s disease per-se does not influence either the course of pregnancy or the condition of the fetus; nor is the course of Hodgkin''s disease in -fluenced by pregnancy. Thus therapeutic abortion need not be considered unless the disease is localized to areas where the fetus would be endangered by direct irradiation; or if the disease is widespread and requires chemotherapy during the first trimester. Chemotherapy should not be employed in localized disease. When active Hodgkin''s disease develops in a pregnant patient, any treatment should be delayed as long as possible to avoid harming the fetus. If at all feasible, no treatment should be administered in the first trimester (the period of major organogenesis). If therapy becomes necessary, local disease should be given the most penetrating radiation possible, to keep the fetal dose to a minimum. Measurements to compare the various radiation therapy units indicated that the internally scattered radiation was the least from the 22.5 Mev betatron, more from the cobalt unit, and most from the 250 kv unit. The principles discussed in this paper may apply to the management of any pregnant patient requiring either radiotherapy or chemotherapy for other malignant disease.