ABSTRACT
An analysis of 233 patients with complete hydatidiform mole admitted to Hacettepe University Hospital between 1964 and 1988 has been carried out. Methotrexate was administered prophylactically to 19 of 120 low-risk and to 52 of 113 high-risk patients. The difference in the incidence of postmolar gestational trophoblastic disease between prophylactically untreated and treated groups of either low-risk (13.9% versus 5.3%, P greater than 0.01) or high-risk (26.2% versus 25.0%, P greater than 0.01) patients was found to be statistically insignificant. Drug toxicity and mortality rates were 16.9% and 2.8%, respectively. It is concluded that prophylactic chemotherapy is not highly effective in the prophylaxis of postmolar gestational trophoblastic disease. Strict follow-up through sensitive betahuman chorionic gonadotropin assays should be the standard management of postmolar patients.
Subject(s)
Hydatidiform Mole/complications , Methotrexate/therapeutic use , Uterine Neoplasms/prevention & control , Female , Humans , Methotrexate/toxicity , Pregnancy , Prognosis , Risk , Trophoblastic Neoplasms/prevention & controlABSTRACT
Forty-nine women who had received chemotherapy for gestational trophoblastic disease subsequently became pregnant a total of 65 times. Of these 65 pregnancies, 42 (64.7%) terminated in term births, 4 (6.1%) in premature births, 1 (1.5%) in stillbirth, 8 (2.3%) in spontaneous abortion and 7 (10.8%) in elective abortion, while 3 patients (4.6%) had repeat molar pregnancies. No congenital malformations or obstetric complications were observed. Treatment of gestational trophoblastic disease with chemotherapy is compatible with the preservation of fertility and is not associated with any increase in congenital fetal malformations.