Chapter 17 - Management of nutritional problems in the pregnant cancer patient

Summary

Standard laboratory assessments, such as CBC, serum albumin, ferritin, and folate, and thyroid function testing (T3, T4, and TSH) may provide some insight into nutritional reserves during pregnancy. It has been hypothesized that the placenta may act as a nutrient sensor to coordinate fetal growth with the ability of the mother to provide nutrients. Studies using fetal blood sampling techniques have determined that amino acid concentrations are higher within the fetus during the second half of pregnancy, that the placenta preferentially transfers arachdonic acid (AA) and docosahexaenoic acid (DHA) to the fetus and that glucose concentrations in fetal circulation are lower in the fetus, however, these change in parallel to maternal concentrations. Supplementation with omega-3 fatty acids does enhance pregnancy duration and, while the evidence is inconclusive, may assist with weight maintenance in cancer patients. Mucositis can be a treatment side effect of both chemotherapy and radiation.