Nanotechnologies in Obstetrics and Cancer during Pregnancy: A Narrative Review

Abstract

Nanotechnology, the art of engineering structures on a molecular level, offers the opportunity to implement new strategies for the diagnosis and management of pregnancy-related disorders. This review aims to summarize the current state of nanotechnology in obstetrics and cancer in pregnancy, focusing on existing and potential applications, and provides insights on safety and future directions. A systematic and comprehensive literature assessment was performed, querying the following databases: PubMed/Medline, Scopus, and Endbase. The databases were searched from their inception to 22 March 2022. Five independent reviewers screened the items and extracted those which were more pertinent within the scope of this review. Although nanotechnology has been on the bench for many years, most of the studies in obstetrics are preclinical. Ongoing research spans from the development of diagnostic tools, including optimized strategies to selectively confine contrast agents in the maternal bloodstream and approaches to improve diagnostics tests to be used in obstetrics, to the synthesis of innovative delivery nanosystems for therapeutic interventions. Using nanotechnology to achieve spatial and temporal control over the delivery of therapeutic agents (e.g., commonly used drugs, more recently defined formulations, or gene therapy-based approaches) offers significant advantages, including the possibility to target specific cells/tissues of interest (e.g., the maternal bloodstream, uterus wall, or fetal compartment). This characteristic of nanotechnology-driven therapy reduces side effects and the amount of therapeutic agent used. However, nanotoxicology appears to be a significant obstacle to adopting these technologies in clinical therapeutic praxis. Further research is needed in order to improve these techniques, as they have tremendous potential to improve the accuracy of the tests applied in clinical praxis. This review showed the increasing interest in nanotechnology applications in obstetrics disorders and pregnancy-related pathologies to improve the diagnostic algorithms, monitor pregnancy-related diseases, and implement new treatment strategies.

Targeted Therapy in the Palliative Treatment of Platinum-Resistant Recurrent Ovarian Cancer Complicated by Ascites

“…Patients included in this retrospective analysis were asked to use pazopanib off-label (together with cyclophosphamide) as part of routine clinical practice and their data were later analysed. Off-label use includes the use of a drug in doses, patient populations, indications or routes of administration that are not reflected in the manufacturer's companyapproved product labelling [3].…”

Stress of Prematurity in the Experience of the COVID-19 Pandemic—Current State of Knowledge

“…However, fetal exposure on nanoformulation, by transplacental transport is still an issue of the debate in gynecological and obstetric profession. Hence, future research is necessary to development of rational, effective and safe treatment for pregnancy-associated cancers [ 33 ].…”

Editorial: Precision Medicine in Obstetrics: Pregnancy Complication

“…Compared to the traditional “one-size-fits-all” strategy, a more specific and targeted approach offers the opportunity for safer and more effective personalized treatments, with improved outcomes and a reduced risk of side effects, which consequently lead patients to a better quality of life and even longer survival [ 1 ]. Bertozzi et al [ 2 ] provide an extensive overview of the application of personalized medicine to obstetrics, focusing on its current applications to overcoming issues currently associated with managing pregnancy-related pathologies (including pre-eclampsia, diabetes, and cancer) and offering insights on the potential role these may play in developing intervention options. The authors also discuss the potential toxicity associated with nanotechnology-based approaches and the difficulties of some of them in crossing the placental barrier, and propose exosomes as a natural nanoscopic alternative with inherent targeting specificity and molecular moieties.…”

“…It comes with limited accessibility, especially in low-middle-income countries, which notoriously suffer from an unequal distribution in healthcare. Furthermore, as a relatively new approach, other concerns exist about its long-term effects and the lack of standardization, which in turn could undermine the comparison of outcomes in determining the most effective treatment [ 2 , 9 ]. In addition, the environmental impact of the production and disposal of nanomaterials is not neglectable [ 10 ], and neither are the ethical concerns surrounding genetic information management in medical care and potential discrimination.…”