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首页> 外文期刊>Gynecologic Oncology: An International Journal >Reproductive outcome after discharge of patients with high-risk hydatidiform mole with or without use of one bolus dose of actinomycin D, as prophylactic chemotherapy, during the uterine evacuation of molar pregnancy.
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Reproductive outcome after discharge of patients with high-risk hydatidiform mole with or without use of one bolus dose of actinomycin D, as prophylactic chemotherapy, during the uterine evacuation of molar pregnancy.

机译：高危葡萄胎的高危患者出院后，在排空磨牙妊娠期间使用或不使用一剂大剂量放线菌素D作为预防性化疗后的生殖结局。

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OBJECTIVE: To evaluate whether prophylactic chemotherapy (P-chem) with one bolus dose of actinomycin D (Act-D) during the uterine evacuation of patients with high-risk hydatidiform mole (Hr-HM) affects reproductive outcomes in subsequent pregnancies. METHODS: From 1987 to 2006, 1090 patients with gestational trophoblastic disease (GTD) were evaluated at a Trophoblastic Disease Center in southern Brazil; 265 with Hr-HM were selected and retrospectively analyzed. From 1996 to 2006, 163 received one bolus dose of Act-D at the time of uterine evacuation (Hr-HM-chem group); 102 with the same risk factors did not get P-chem (Hr-HM-control group). In March 2009, the number of pregnancies, progression of first pregnancy, and association of low age and low parity with subsequent pregnancy were evaluated. RESULTS: The percentage of patients that became pregnant was similar in both groups (Hr-HM-control: 59.5%; Hr-HM-chem group: 45.7%; p=0.069) and independent of HM progression. Percentages of no pregnancies because of age (> or =40 years) or hysterectomy were also similar. Type of subsequent pregnancy was not statistically different between groups, and the rate of live births associated with pregnancies for which US showed a live fetus was high. Frequency of repeat GTD was unexpectedly high in both groups (4.2% and 6.3%; p=1.00). CONCLUSIONS: P-chem did not affect reproductive outcomes for patients with Hr-HM. Patients allowed to become pregnant again in both groups had high rates of live births associated with normal pregnancies. Chances of a subsequent pregnancy were higher in the low age and low parity subgroups.
机译：目的：评估在高风险葡萄胎（Hr-HM）患者的子宫排空过程中，单次推注放线菌素D（Act-D）的预防性化疗（P-chem）是否会影响后续妊娠的生殖结果。方法：1987年至2006年，在巴西南部的滋养细胞疾病中心对1090例妊娠滋养细胞疾病（GTD）患者进行了评估。选择265例Hr-HM并进行回顾性分析。从1996年到2006年，有163人在子宫排空时接受了一剂大剂量的Act-D（Hr-HM-chem组）。具有相同危险因素的102例未进行P-chem治疗（Hr-HM对照组）。在2009年3月，评估了怀孕次数，第一次妊娠的进展以及低龄和低胎次与随后妊娠的关联。结果：两组的妊娠患者百分比相似（Hr-HM对照组：59.5％; Hr-HM-chem组：45.7％; p = 0.069），且与HM进展无关。由于年龄（>或= 40岁）或子宫切除术而未怀孕的百分比也相似。两组之间的随后妊娠类型在统计学上没有统计学差异，并且US显示其活产胎儿的与妊娠相关的活产率很高。两组中重复GTD的频率出乎意料的高（4.2％和6.3％; p = 1.00）。结论：P-chem不会影响Hr-HM患者的生殖结局。两组中允许再次怀孕的患者的活产率均与正常妊娠相关。低年龄和低同等亚组中随后怀孕的机会更高。

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