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Management of massive hemorrhage in patients with gestational trophoblastic neoplasia by angiographic embolization: a safer alternative.
MedLine Citation:
PMID:  21682119     Owner:  NLM     Status:  In-Process    
Abstract/OtherAbstract:
OBJECTIVE: To assess the usefulness of angiographic embolization in hemorrhage due to gestational trophoblastic neoplasia (GTN).
STUDY DESIGN: We conducted a retrospective analysis of data of patients with gestational trophoblastic disease within the time period 2002-2008.
RESULTS: Eight women with GTN presented with massive hemorrhage during this time period. According to the International Federation of Gynecology and Obstetrics Scoring system 2000, 4 of those patients had high-risk GTN. Vaginal metastasis was present in 50% of the women. All women underwent angiography, and embolization was performed in 7 of the 8 patients. One patient could not undergo embolization due to technical reasons. Two patients underwent embolization of bilateral internal iliac arteries, 4 had bilateral uterine artery embolization and 1 had bilateral uterine and hepatic artery embolization. Embolization was successful in 85.7% of the patients. All patients received chemotherapy: high-risk patients received combined regimen chemotherapy (EMA-CO), while low-risk cases received methotrexate/folinic acid regimen. Out of the 8 patients, 5 are in remission and 3 succumbed to the disease. In 2 women who tried to conceive, 1 delivered a term infant and the other had a miscarriage. The most common side effect of embolization was pain requiring parenteral analgesia.
CONCLUSION: Transcatheter embolization is a safe and quick procedure and should be considered in GTN patients with acute hemorrhagic life-threatening complications.
Authors:
Anish Keepanasseril; Vanita Suri; G R V Prasad; Vivek Gupta; Rashmi Bagga; Neelam Aggarwal; Lakhbir Kaur Dhaliwal; Niranjan Khandelwal
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The Journal of reproductive medicine     Volume:  56     ISSN:  0024-7758     ISO Abbreviation:  J Reprod Med     Publication Date:    2011 May-Jun
Date Detail:
Created Date:  2011-06-20     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0173343     Medline TA:  J Reprod Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  235-40     Citation Subset:  IM    
Affiliation:
Departments of Obstetrics and Gynecology and of Radiodiagnosis, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
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