Document Detail


Pregnancy after EMA/CO for gestational trophoblastic disease: a report from The Netherlands.
MedLine Citation:
PMID:  12798472     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To investigate whether a desire for pregnancy changed after etoposide, methotrexate, actinomycin D, cyclophosphamide and vincristine (EMA/CO) treatment for gestational trophoblastic disease and whether the incidence of infertility and adverse pregnancy outcome differed from the general population. DESIGN: A cohort study was performed. Data were collected from hospital records and questionnaires. SETTING: The study was carried out in referral hospitals in The Netherlands. POPULATION: All women registered by the Dutch Working Party on Trophoblastic Disease and treated with EMA/CO were included. METHODS: A questionnaire was sent to all surviving patients treated with EMA/CO from 1986 until 1997. Women who underwent a hysterectomy were excluded from the study. MAIN OUTCOME MEASURE: Pregnancy outcome and pregnancy wish after chemotherapy. RESULTS: Fifty patients were treated with EMA/CO. In 86%, a complete remission was achieved. A questionnaire was sent to 33 patients. Response rate was 82% (27/33). After EMA/CO, 18 of the patients experienced a regular menstrual cycle. Three patients had an amenorrhoea. Fourteen patients had a pregnancy wish. Twelve patients conceived; 21 pregnancies occurred. Sixteen pregnancies were term deliveries. Two pregnancies ended in a miscarriage and two congenitally abnormal children were delivered prematurely. CONCLUSION: After EMA/CO, 86% of women with a pregnancy wish achieved pregnancy. However, women can be so anxious about a new pregnancy that they refrain from it. A causative relation between the two congenitally abnormal children and EMA/CO cannot be determined because of the small sample. The rate of miscarriages is not higher than in the general population. We can reassure patients that pregnancy after EMA/CO has a high probability of success and a favourable outcome. To diminish the fear of getting pregnant in some patients, psychosocial care should be considered in addition to medical care.
Authors:
C A R Lok; C van der Houwen; M J ten Kate-Booij; M A van Eijkeren; A C Ansink
Publication Detail:
Type:  Journal Article; Multicenter Study    
Journal Detail:
Title:  BJOG : an international journal of obstetrics and gynaecology     Volume:  110     ISSN:  1470-0328     ISO Abbreviation:  BJOG     Publication Date:  2003 Jun 
Date Detail:
Created Date:  2003-06-11     Completed Date:  2003-08-07     Revised Date:  2006-04-24    
Medline Journal Info:
Nlm Unique ID:  100935741     Medline TA:  BJOG     Country:  England    
Other Details:
Languages:  eng     Pagination:  560-6     Citation Subset:  AIM; IM    
Affiliation:
Department of Obstetrics and Gynaecology, Academic Medical Center, Amsterdam, The Netherlands.
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MeSH Terms
Descriptor/Qualifier:
Adult
Antineoplastic Combined Chemotherapy Protocols / administration & dosage,  therapeutic use*
Anxiety / etiology
Attitude to Health
Cohort Studies
Cyclophosphamide / administration & dosage
Dactinomycin / administration & dosage
Etoposide / administration & dosage
Female
Humans
Hydatidiform Mole / drug therapy,  psychology*
Methotrexate / administration & dosage
Middle Aged
Motivation*
Netherlands
Pregnancy / psychology*
Pregnancy Outcome
Prognosis
Uterine Neoplasms / drug therapy,  psychology*
Vincristine / administration & dosage
Chemical
Reg. No./Substance:
0/EMA-CO protocol; 33419-42-0/Etoposide; 50-18-0/Cyclophosphamide; 50-76-0/Dactinomycin; 57-22-7/Vincristine; 59-05-2/Methotrexate

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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