Abstract
For reasons ranging from access to care, utilization of healthcare services by young adults and the maternal physiologic changes of pregnancy, emergency department (ED) providers may be the first to discover an undiagnosed malignancy. Cancer complicates roughly 1 of every 1,000 pregnancies (E. Cardonick, 2004). The purpose of this article is to raise the consciousness of ED providers regarding the importance of screening for hematologic disease in pregnant patients and to provide a brief review of the current literature discussing acute lymphocytic leukemia in pregnancy. A case presentation of a real patient is provided as a possible teaching tool and for discussion of differential diagnoses and course of treatment. Acute leukemia must be treated aggressively in the pregnant patient. Retrospective studies have outlined the potential maternal and fetal outcomes of induction, consolidation, and chemotherapy in the first, second, and third trimesters. Acute leukemia is fatal if untreated and ultimately the patient must make difficult decisions. ED providers can then make thoughtful recommendations on the basis of the evidence-based practice.