[The reproductive function following a hydatidiform mole].

This paper starts with a short description of the history of the discovery of the hydatidiform mole ( Tulp in 1641) and of the treatment (before 1956, hysterectomy in most cases). After 1961 chemotherapy started to be used even in patients who had cerebral metastases. 72 patients who had attended Professor Hubinont 's department in the University Hospital of Saint-Pierre in Brussels between January 1971 and December 1981 were followed up. Questionnaires were sent to the patients and to their doctors who were treating them in order to try and find out what had happened in subsequent pregnancies and what the maternal and fetal consequences and complications were. The social class and the marital status of the patients was also considered as well as their wish to become pregnant again. Of the 72 cases that were followed up after evacuation 63 (87.5%) recovered while 9(12.5%) had clinical, biological or radiological signs of persistent non-metastatic (3) and metastatic (6 cases) active disease. The department asked patients not to become pregnant in the year following evacuation of the mole. 10% were sterilised, 4 by hysterectomy and 4 by tubal ligation. 42% used the oral contraceptive pill and 34% (24 cases) condoms. Control follow-up of patients who became pregnant was compared with a group of 2 529 pregnancies in Saint-Pierre Hospital during the year 1981. 44 out of the 72 patients who were followed up after hydatidiform mole became pregnant with a total of 52 pregnancies. Ten became pregnant in the first 6 months after attempting it, 11 between 6 and 12 months and 23 after a delay of 12 months. Out of the 52 pregnancies, 34 5%) had a live baby at term. 6 were premature and 31 out of 34 babies delivered at term were delivered vaginally and 3 by Caesarean. There were 9 spontaneous abortions (17%) and 2 terminations of pregnancy (4%). Three patients had repeated non-intentional abortions and one had a still-birth for which the cause could not be found. Only one other had a second mole. When these results are compared with the histories of these patients before they had the hydatidiform mole there did not seem to be any increase in the number of spontaneous abortions or premature labours, nor was there when this group was compared with a control group. Only one of the 38 live-born children showed a major congenital abnormality which was varus equinus. There was no possibility of picking out statistically anything of value as far as congenital malformations was concerned.