Cancer in pregnancy: FIGO Best practice advice and narrative review

Surabhi Nanda^{1

2}, Melanie Nana^{1

2}, Long Nguyen-Hoang^{3

4}, Sumaiya Adam^{5

6}, Fionnuala McAuliffe⁷, Lina Bergman^{8

9

10}, Sarikapan Wilailak¹¹, Orla McNally¹², Cynthia V Maxwell¹³, Nikhil Purandare¹⁴, Bo Jacobsson^{15

16}, Virna P Medina¹⁷, Anil Kapur¹⁸, Titus Beyuo¹⁹, Francisco Ruiloba²⁰, Ernesto Castelazo²¹, Graeme N Smith²², Sharleen L O'Reilly^{7

23}, Patrick O'Brien²⁴, Mark Hanson^{25

26}, Mary L Rosser²⁷, Claudio Sosa²⁸, Valerie Guinto²⁹, Jonathan Berek³⁰, Catherine Nelson-Piercy^{1

2}, Frédéric Amant^{31

32}, Liona Poon³; FIGO Committee on the Impact of Pregnancy on Long‐term Health, FIGO Committee on Women's Cancer, and the FIGO Division of Maternal and Newborn Health

Affiliations

¹ Women's Directorate, Guy's and St. Thomas' Hospital, Evelina London Children's Hospital, King's College London, London, UK.
² Faculty of Life Sciences and Medicine, King's College London, London, UK.
³ Department of Obstetrics and Gynecology, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong, SAR, China.
⁴ Fetal Medicine Center, Tam Anh HCMC General Hospital, Ho Chi Minh City, Vietnam.
⁵ Department of Obstetrics and Gynecology, School of Medicine, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa.
⁶ Diabetes Research Centre, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa.
⁷ UCD Perinatal Research Centre, School of Medicine, University College Dublin, National Maternity Hospital, Dublin, Ireland.
⁸ Department of Obstetrics and Gynecology, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
⁹ Department of Obstetrics and Gynecology, Stellenbosch University, Cape Town, South Africa.
¹⁰ Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden.
¹¹ Faculty of Medicine Ramathibodi Hospital, Department of Obstetrics and Gynecology, Mahidol University, Bangkok, Thailand.
¹² Oncology and Dysplasia Services, Royal Women's Hospital, Melbourne, Australia.
¹³ Maternal Fetal Medicine, Sinai Health and Women's College Hospital, University of Toronto, Ontario, Canada.
¹⁴ University of Galway, Galway, Ireland.
¹⁵ Department of Obstetrics and Gynecology, Sahlgrenska University Hospital, Ostra, Gothenburg, Sweden.
¹⁶ Department of Genetics and Bioinformatics, Domain of Health Data and Digitalization, Institute of Public Health, Oslo, Norway.
¹⁷ Department of Obstetrics and Gynecology, Faculty of Health, Universidad del Valle, Clínica Imbanaco Quirón Salud, Universidad, Libre, Cali, Colombia.
¹⁸ World Diabetes Foundation, Bagsvaerd, Denmark.
¹⁹ Department of Obstetrics and Gynecology, University of Ghana Medical School, Accra, Ghana.
²⁰ Fetal Medicine Research Institute, King's College Hospital, London, UK.
²¹ International Federation of Gynecology and Obstetrics, London, UK.
²² Department of Obstetrics & Gynecology, Kingston Health Sciences Centre, Queen's University, Kingston, Ontario, Canada.
²³ School of Agriculture and Food Science, University College Dublin, Dublin, Ireland.
²⁴ Institute for Women's Health, University College London, London, UK.
²⁵ Institute of Developmental Sciences, University Hospital Southampton, Southampton, UK.
²⁶ NIHR Southampton Biomedical Research Centre, University of Southampton, Southampton, UK.
²⁷ Department of Obstetrics and Gynecology, Columbia University Irving Medical Center, New York-Presbyterian, New York, New York, USA.
²⁸ Department of Obstetrics and Gynecology, School of Medicine, University of Uruguay, Montevideo, Uruguay.
²⁹ Department of Obstetrics and Gynecology, St. Luke's Medical Center Global City, University of the Philippines-Philippine General Hospital, Manila, Philippines.
³⁰ Stanford Women's Cancer Center, Laurie Kraus Lacob Professor Stanford University School of Medicine, Stanford, California, USA.
³¹ Division Gynecologic Oncology, UZ Leuven, Leuven, Belgium.
³² Department of Oncology, KU Leuven, Leuven, Belgium.

PMID: 40704672
PMCID: PMC12447680
DOI: 10.1002/ijgo.70258

Review

Cancer in pregnancy: FIGO Best practice advice and narrative review

Surabhi Nanda et al. Int J Gynaecol Obstet. 2025 Oct.

. 2025 Oct;171(1):131-151.

doi: 10.1002/ijgo.70258. Epub 2025 Jul 24.

Authors

Affiliations

¹ Women's Directorate, Guy's and St. Thomas' Hospital, Evelina London Children's Hospital, King's College London, London, UK.
² Faculty of Life Sciences and Medicine, King's College London, London, UK.
³ Department of Obstetrics and Gynecology, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong, SAR, China.
⁴ Fetal Medicine Center, Tam Anh HCMC General Hospital, Ho Chi Minh City, Vietnam.
⁵ Department of Obstetrics and Gynecology, School of Medicine, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa.
⁶ Diabetes Research Centre, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa.
⁷ UCD Perinatal Research Centre, School of Medicine, University College Dublin, National Maternity Hospital, Dublin, Ireland.
⁸ Department of Obstetrics and Gynecology, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
⁹ Department of Obstetrics and Gynecology, Stellenbosch University, Cape Town, South Africa.
¹⁰ Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden.
¹¹ Faculty of Medicine Ramathibodi Hospital, Department of Obstetrics and Gynecology, Mahidol University, Bangkok, Thailand.
¹² Oncology and Dysplasia Services, Royal Women's Hospital, Melbourne, Australia.
¹³ Maternal Fetal Medicine, Sinai Health and Women's College Hospital, University of Toronto, Ontario, Canada.
¹⁴ University of Galway, Galway, Ireland.
¹⁵ Department of Obstetrics and Gynecology, Sahlgrenska University Hospital, Ostra, Gothenburg, Sweden.
¹⁶ Department of Genetics and Bioinformatics, Domain of Health Data and Digitalization, Institute of Public Health, Oslo, Norway.
¹⁷ Department of Obstetrics and Gynecology, Faculty of Health, Universidad del Valle, Clínica Imbanaco Quirón Salud, Universidad, Libre, Cali, Colombia.
¹⁸ World Diabetes Foundation, Bagsvaerd, Denmark.
¹⁹ Department of Obstetrics and Gynecology, University of Ghana Medical School, Accra, Ghana.
²⁰ Fetal Medicine Research Institute, King's College Hospital, London, UK.
²¹ International Federation of Gynecology and Obstetrics, London, UK.
²² Department of Obstetrics & Gynecology, Kingston Health Sciences Centre, Queen's University, Kingston, Ontario, Canada.
²³ School of Agriculture and Food Science, University College Dublin, Dublin, Ireland.
²⁴ Institute for Women's Health, University College London, London, UK.
²⁵ Institute of Developmental Sciences, University Hospital Southampton, Southampton, UK.
²⁶ NIHR Southampton Biomedical Research Centre, University of Southampton, Southampton, UK.
²⁷ Department of Obstetrics and Gynecology, Columbia University Irving Medical Center, New York-Presbyterian, New York, New York, USA.
²⁸ Department of Obstetrics and Gynecology, School of Medicine, University of Uruguay, Montevideo, Uruguay.
²⁹ Department of Obstetrics and Gynecology, St. Luke's Medical Center Global City, University of the Philippines-Philippine General Hospital, Manila, Philippines.
³⁰ Stanford Women's Cancer Center, Laurie Kraus Lacob Professor Stanford University School of Medicine, Stanford, California, USA.
³¹ Division Gynecologic Oncology, UZ Leuven, Leuven, Belgium.
³² Department of Oncology, KU Leuven, Leuven, Belgium.

PMID: 40704672
PMCID: PMC12447680
DOI: 10.1002/ijgo.70258

Abstract

Cancer during pregnancy is relatively rare. The incidence is underestimated due to the lack of international registries covering both high-income and low- and middle-income countries, and is expected to rise with increasing maternal age and increasing global adoption of cell-free DNA testing for aneuploidy. Physiological changes during pregnancy often make the diagnosis challenging and delayed. Lack of experience and knowledge about this condition may also contribute to late diagnosis, suboptimal management, and occasionally inadvertent fetal and/or maternal harm. The principles of cancer management in pregnancy for most cancer types do not differ significantly from the non-pregnant population. The impact of investigations for diagnosis and staging, risks of surgery, systemic chemotherapy, and/or radiotherapy on fetal well-being and preterm birth need to be considered for treatment and management planning, in addition to maternal wishes. Working in a multidisciplinary setting, ideally with medical and radiation oncologists, surgeons, radiologists, cancer specialist nurses, geneticists, psychologists, teratologists, and clinical pharmacologists, obstetricians, obstetric physicians, neonatologists, and experienced nursing and midwifery staff helps provide optimal care for the woman. This best practice advice aims to provide recommendations on the diagnosis and management of cancer in pregnancy, which can be adopted in all resource settings.

Keywords: abortion; cancer; chemotherapy; miscarriage; pregnancy; prematurity; radiotherapy; staging; termination.

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Conflict of interest statement

The authors have no conflicts of interest.

Figures

**FIGURE 1**
(a) Comparison of nature of the malignancies in the women who died in pregnancy to up to one year after delivery in UK and Ireland between 2017–19 and 2021–22., (b) Data from the INCIP registry: (i) distribution of cancers during pregnancy and (ii) stage of disease at diagnosis by cancer type. Stage of disease was available for all solid cancers with TNM or FIGO classification. *Ovarian cancers include borderline ovarian tumors. ^†Consists of 25 different cancer types. Reproduced from de Haan J, et al. with permission from Elsevier

**FIGURE 2**
Multidisciplinary team input for women with cancer in pregnancy.

**FIGURE 3**
(a) Quick reference guideline for management of breast cancer in pregnancy. (b) Quick reference guideline for management of breast cancer in pregnancy.

See this image and copyright information in PMC

References

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Cancer in pregnancy: FIGO Best practice advice and narrative review

Affiliations

Cancer in pregnancy: FIGO Best practice advice and narrative review

Authors

Affiliations

Abstract

Conflict of interest statement

Figures

References

Publication types

MeSH terms

LinkOut - more resources

Full Text Sources

Medical