Kan Momo, Yamamoto Eiko, Niimi Kaoru, Tamakoshi Koji, Sekiya Yoko, Nishino Kimihiro, Ino Kazuhiko, Kikkawa Fumitaka
J Reprod Med. 2016 Aug;61(7-8):373-379.
To investigate gestational trophoblastic neoplasia (GTN), fertility, and pregnancy outcome in molar patients who underwent routine second curettage.
Eighty-two patients who visited our hospital for hydatidi- form mole between 2002 and 2011 were registered in this study. All patients had sec- ond curettage around the 7th day after first evacuation. We performed retrospective analysis on several factors between a remission group and a GTN group.
Fourteen patients (17.1%) had chemotherapy after being diagnosed with GTN. Multivariate analysis revealed that the hCG value before first evac- uation was only one independent prognostic factor for GTN. The median follow-up period was 45.5 months, and 41 patients had 62 pregnancies after remission of hydatidiform mole and GTN. The fertility rate was 80% in 45 patients with desire for a baby, and 39 pregnancies (62.9%) ended in live births without congenital malformation.
The incidence of GTN was not lower in hydatidiform mole with routine second curettage. An independent prognostic factor for GTN- was the hCG value before the first evac- uation in molar patients. Our results suggest that rou- tine second curettage does not affect the fertility rate or increase a risk of adverse outcomes in subsequent prej- nancies.
探讨接受常规二次刮宫的葡萄胎患者的妊娠滋养细胞肿瘤（GTN）、生育力及妊娠结局。
本研究纳入了2002年至2011年间因葡萄胎前来我院就诊的82例患者。所有患者在首次清宫后第7天左右进行了二次刮宫。我们对缓解组和GTN组之间的几个因素进行了回顾性分析。
14例患者（17.1%）在被诊断为GTN后接受了化疗。多因素分析显示，首次清宫前的hCG值是GTN唯一的独立预后因素。中位随访期为45.5个月，41例患者在葡萄胎和GTN缓解后有62次妊娠。45例有生育意愿的患者的生育率为80%，39次妊娠（62.9%）以活产告终，且无先天性畸形。
常规二次刮宫的葡萄胎患者中GTN的发生率并不低。GTN的一个独立预后因素是葡萄胎患者首次清宫前的hCG值。我们的结果表明，常规二次刮宫不会影响生育率，也不会增加后续妊娠不良结局的风险。
