Prophylactic chemotherapy for hydatidiform mole to prevent gestational trophoblastic neoplasia.

摘要: A molar pregnancy (hydatidiform mole) develops following an abnormal process of conception, whereby placental tissue overgrows inside the womb (uterus). Molar pregnancies are classified as complete (CM) or partial (PM) based on their appearance (gross and microscopic), chromosome pattern. Moles usually suspected at early scan women often present with bleeding, similar to a miscarriage. The is removed by evacuation retained products conception (ERPC), also known dilatation curettage (D&C) generally make full recovery. However, some go develop cancer in (about 1 every 5 CM 200 PM). Women higher risk getting this cancer, which gestational trophoblastic neoplasia (GTN), if they over 40 years old, have large increase size womb, cysts ovaries high initial levels β-human chorionic gonadotrophin (hCG) (the hormone) blood. Although treatment chemotherapy (anti-cancer drugs) almost always effective, it has been suggested that routinely giving anti-cancer drugs (P-Chem) before after removal may reduce cancerous developing. By doing review, we tried assess benefits risks P-Chem pregnancies, ERPC. We found three randomised studies involving total 613 women. Two tested methotrexate all one study dactinomycin who were GTN. two older used relatively poor research methods, therefore findings cannot be relied upon. Overall review suggest reduces number developing pregnancy; however, probably only true for high-risk moles. In addition, might time diagnosing longer treatments needed cure develops. unable short- long-term side-effects because there was not enough available data; concerned five- eight-day courses researchers these too toxic given routinely. Currently insufficient evidence support pregnancies. GTN cured modern care would needing full-scale chemotherapy, but remove risk. change need careful monitoring follow-up hydatidiform