| Reproductive outcome after discharge of patients with high-risk hydatidiform mole with or without use of one bolus dose of actinomycin D, as prophylactic chemotherapy, during the uterine evacuation of molar pregnancy. | |
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MedLine Citation:
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PMID: 19818481 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVE: To evaluate whether prophylactic chemotherapy (P-chem) with one bolus dose of actinomycin D (Act-D) during the uterine evacuation of patients with high-risk hydatidiform mole (Hr-HM) affects reproductive outcomes in subsequent pregnancies. METHODS: From 1987 to 2006, 1090 patients with gestational trophoblastic disease (GTD) were evaluated at a Trophoblastic Disease Center in southern Brazil; 265 with Hr-HM were selected and retrospectively analyzed. From 1996 to 2006, 163 received one bolus dose of Act-D at the time of uterine evacuation (Hr-HM-chem group); 102 with the same risk factors did not get P-chem (Hr-HM-control group). In March 2009, the number of pregnancies, progression of first pregnancy, and association of low age and low parity with subsequent pregnancy were evaluated. RESULTS: The percentage of patients that became pregnant was similar in both groups (Hr-HM-control: 59.5%; Hr-HM-chem group: 45.7%; p=0.069) and independent of HM progression. Percentages of no pregnancies because of age (> or =40 years) or hysterectomy were also similar. Type of subsequent pregnancy was not statistically different between groups, and the rate of live births associated with pregnancies for which US showed a live fetus was high. Frequency of repeat GTD was unexpectedly high in both groups (4.2% and 6.3%; p=1.00). CONCLUSIONS: P-chem did not affect reproductive outcomes for patients with Hr-HM. Patients allowed to become pregnant again in both groups had high rates of live births associated with normal pregnancies. Chances of a subsequent pregnancy were higher in the low age and low parity subgroups. |
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Authors:
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Elza Maria Hartmann Uberti; Maria do Carmo Fajardo; Silvia Villa Verde Ribeiro Ferreira; Maurício Vannoni Pereira; Raquel Cristina Seger; Maria Amélia Rolla Moreira; Magali Duarte Torres; Gilberto de Nápoli; Helena Schmid |
Publication Detail:
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Type: Clinical Trial; Journal Article Date: 2009-10-08 |
Journal Detail:
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Title: Gynecologic oncology Volume: 115 ISSN: 1095-6859 ISO Abbreviation: Gynecol. Oncol. Publication Date: 2009 Dec |
Date Detail:
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Created Date: 2009-11-03 Completed Date: 2009-12-01 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 0365304 Medline TA: Gynecol Oncol Country: United States |
Other Details:
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Languages: eng Pagination: 476-81 Citation Subset: IM |
Affiliation:
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TDC of CHSCPA, Universidade Federal de Ciências da Saúde de Porto Alegre, Porto Alegre, RS, Brazil. elzauberti@terra.com.br |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adult Combined Modality Therapy Dactinomycin / administration & dosage* Female Humans Hydatidiform Mole / drug therapy*, surgery* Pregnancy Pregnancy Outcome Reproduction Young Adult |
| Chemical | |
Reg. No./Substance:
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50-76-0/Dactinomycin |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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