Unintended pregnancy during radiotherapy for cancer

Background A 27-year-old woman with upper mediastinum stage IIA Hodgkin lymphoma was treated with six cycles of doxorubicin, bleomycin, vinblastine, and dacarbazine chemotherapy. Two months later she received a total of 4,250 cGy to the upper mediastinum and left clavicular region over a 1-month period. One week after completion of radiotherapy she was found to be 13-weeks pregnant. Her physician advised her to terminate pregnancy. She contacted a teratology information service for further information regarding the risks of radiation exposure for her fetus. Investigations Estimation of fetal radiation exposure, literature review and synthesis of published cases and effects of fetal radiation exposure. Diagnosis Estimated fetal radiation dose between 5 and 18 cGy. Management Counseling on the possible risks to the fetus as a result of radiation exposure.