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.

摘要: Abstract Objective To evaluate whether prophylactic chemotherapy (P-chem) with one bolus dose of actinomycin D (Act-D) during the uterine evacuation patients high-risk hydatidiform mole (Hr-HM) affects reproductive outcomes in subsequent pregnancies. Methods From 1987 to 2006, 1090 gestational trophoblastic disease (GTD) were evaluated at a Trophoblastic Disease Center southern Brazil; 265 Hr-HM selected and retrospectively analyzed. 1996 163 received Act-D time (Hr-HM-chem group); 102 same risk factors did not get P-chem (Hr-HM-control group). In March 2009, number pregnancies, progression first pregnancy, association low age parity pregnancy evaluated. Results The percentage that became pregnant was similar both groups (Hr-HM-control: 59.5%; Hr-HM-chem group: 45.7%; p = 0.069) independent HM progression. Percentages no pregnancies because (≥ 40 years) or hysterectomy also similar. Type statistically different between groups, rate live births associated for which US showed fetus high. Frequency repeat GTD unexpectedly high (4.2% 6.3%; p = 1.00). Conclusions affect Hr-HM. Patients allowed become again had rates normal Chances higher subgroups.