Zhu L, Song H, Yang X, Xiang Y
Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China.
Chin Med J (Engl). 1998 Nov;111(11):1004-6.
To determine the risk of pregnancy for patients who conceive within one year after successful chemotherapy for gestational trophoblastic tumor (GTT).
We followed up and analysed retrospectively 22 patients who conceived within one year after receiving chemotherapy for GTT from 1966 through 1996.
Of 22 patients, 9 had term delivery, 1 had premature birth, 6 requested induced abortion, and 6 experienced therapeutic abortion because of repeated hydatidiform mole (1 patient), intrauterine death (1), inevitable abortion (1), or threatened abortion (3). The fetal wastage rate was 27.3% (6/22). The incidence of gestational trophoblastic disease (GTD), including hydatidiform mole, was 9.1% (2/22). The incidence of GTT was 4.5%. The average interval between completion of chemotherapy and pregnancy was 9.78 months in the group of term pregnancy and 6.50 months in the group of fetal wastage (P < 0.05).
Patients conceiving within one year after successful chemotherapy for GTT are at higher risk for recurrence of GTD and fetal wastage. Therefore, patients with preserved fertility should practice contraception for at least one year after chemotherapy to get better pregnancy outcome.
确定妊娠滋养细胞肿瘤(GTT)化疗成功后一年内受孕患者的妊娠风险。
我们对1966年至1996年期间接受GTT化疗后一年内受孕的22例患者进行了随访并进行回顾性分析。
22例患者中,9例足月分娩,1例早产,6例要求人工流产,6例因复发性葡萄胎(1例)、宫内死亡(1例)、难免流产(1例)或先兆流产(3例)而接受治疗性流产。胎儿丢失率为27.3%(6/22)。妊娠滋养细胞疾病(GTD,包括葡萄胎)的发生率为9.1%(2/22)。GTT的发生率为4.5%。足月妊娠组化疗结束至妊娠的平均间隔为9.78个月,胎儿丢失组为6.50个月(P<0.05)。
GTT化疗成功后一年内受孕的患者发生GTD复发和胎儿丢失的风险较高。因此,有生育能力的患者化疗后应至少避孕一年,以获得更好的妊娠结局。