scholarly journals Pregnancy outcomes after chemotherapy for trophoblastic neoplasia

2016 ◽  
Vol 62 (9) ◽  
pp. 837-842
Author(s):  
MILA TREMENTOSA GARCIA ◽  
LAWRENCE HSU LIN ◽  
KOJI FUSHIDA ◽  
ROSSANA PULCINELI VIEIRA FRANCISCO ◽  
MARCELO ZUGAIB
Keyword(s):  
Congenital Abnormalities ◽  
Gestational Trophoblastic Disease ◽  
Subsequent Pregnancy ◽  
Cochrane Library ◽  
Reproductive Outcomes ◽  
Successful Development ◽  
Disease Remission ◽  
Trophoblastic Disease ◽  
Clinical Surveillance ◽  
Hydatidiform Moles

SUMMARY Introduction The successful development of chemotherapy enabled a fertilitysparing treatment for patients with trophoblastic neoplasia. After disease remission, the outcome of a subsequent pregnancy becomes a great concern for these women. Objective To analyze existing studies in the literature that describe the reproductive outcomes of patients with trophoblastic neoplasia treated with chemotherapy. Method Systematic review was performed searching for articles on Medline/ Pubmed, Lilacs and Cochrane Library databases, using the terms “gestational trophoblastic disease” and “pregnancy outcome”. Results A total of 18 articles were included. No evidence of decreased fertility after chemotherapy for trophoblastic neoplasia was observed. The abortion rates in patients who conceived within 6 months after chemotherapy was higher compared to those who waited longer. Some studies showed increased rates of stillbirth and repeat hydatidiform moles. Only one work showed increased congenital abnormalities. Conclusion The pregnancies conceived after chemotherapy for trophoblastic neoplasia should be followed with clinical surveillance due to higher rates of some pregnancy complications. However, studies in the literature provide reassuring data about reproductive outcomes of these patients.

Influence of Chemotherapy for Gestational Trophoblastic Disease on Subsequent Pregnancy Outcome

1999 ◽  
Vol 54 (2) ◽  
pp. 108-109
Author(s):  
Robert P. Woolas ◽  
Mark Bower ◽  
Edward S. Newlands ◽  
Michael Seckl ◽  
Dee Short ◽  
...  
Keyword(s):  
Pregnancy Outcome ◽  
Gestational Trophoblastic Disease ◽  
Subsequent Pregnancy ◽  
Trophoblastic Disease

scholarly journals Hyperthyroidism in gestational trophoblastic disease – a literature review

2021 ◽  
Vol 14 (1) ◽  
Author(s):  
Jarett Vanz-Brian Pereira ◽  
Taylor Lim
Keyword(s):  
Risk Factors ◽  
Early Detection ◽  
Gestational Trophoblastic Disease ◽  
Thyroid Stimulating Hormone ◽  
Cochrane Library ◽  
Thyroid Storm ◽  
High Risk Women ◽  
Trophoblastic Disease ◽  
Full Text Review ◽  
Thyrotropic Activity

Abstract Objective Gestational trophoblastic disease (GTD) is a group of pregnancy-related disorders that arise from abnormal proliferation of placental trophoblast. Some patients with GTD develop hyperthyroidism, a rare but potentially life-threatening complication requiring early detection and management. Existing literature on hyperthyroidism in GTD is scant. This review aims to analyse the epidemiology, pathophysiology and management of this phenomenon. Methods A comprehensive search of MEDLINE, EMBASE and Cochrane Library was performed to obtain articles that explored hyperthyroidism in GTD. A total of 405 articles were screened and 228 articles were considered for full-text review. We selected articles that explored epidemiology, pathophysiology and outcomes/management of hyperthyroidism in GTD. Results The pathophysiology of hyperthyroidism in GTD is well-investigated. Placental trophoblastic tissue secretes excessive hCG, which is structurally similar to thyroid stimulating hormone and also has enhanced thyrotropic activity compared to normal hCG. The incidence and prevalence of hyperthyroidism in GTD varies worldwide, with lower rates associated with high uptake of early antenatal screening and early GTD detection. No clear risk factors for hyperthyroidism in GTD were identified. While hyperthyroidism can be definitively managed with surgical evacuation of the uterus, severe complications associated with hyperthyroidism in GTD have been reported, including thyroid storm-induced multi-organ failure, ARDS, and pulmonary hypertension. Conclusion Early detection of GTD is critical to prevent development of hyperthyroidism and its associated complications. Hyperthyroidism should be recognised as an important perioperative consideration for women undergoing surgery for GTD, and requires appropriate management. Future studies should explore risk factors for hyperthyroidism in GTD, which may facilitate earlier identification of high-risk women.

Influence of chemotherapy for gestational trophoblastic disease on subsequent pregnancy outcome

1998 ◽  
Vol 105 (9) ◽  
pp. 1032-1035 ◽  
Author(s):  
Robert P. Woolas ◽  
Mark Bower ◽  
Edward S. Newlands ◽  
Michael Seckl ◽  
Dee Short ◽  
...  
Keyword(s):  
Pregnancy Outcome ◽  
Gestational Trophoblastic Disease ◽  
Subsequent Pregnancy ◽  
Trophoblastic Disease

Invasive mole presenting as a heavily bleeding vaginal lesion 3 weeks after uterine evacuation

2021 ◽  
Vol 14 (6) ◽  
pp. e242208
Author(s):  
Rita Mamede ◽  
Mariana Beja ◽  
Dusan Djokovic ◽  
Cristina Costa
Keyword(s):  
Surgical Intervention ◽  
Lung Metastases ◽  
Gestational Trophoblastic Disease ◽  
Primiparous Woman ◽  
Trophoblastic Disease ◽  
Multiple Agent ◽  
Metastatic Nodule ◽  
History Of ◽  
Invasive Mole ◽  
Hydatidiform Moles

Gestational trophoblastic disease occurs in 1–3:1000 gestations worldwide. Up to one-fifth of complete hydatidiform moles undergo malignant transformation, with 2%–4% manifesting as metastatic disease. Of these, a third present with vaginal metastases, which can cause bleeding and discharge. We describe the case of a 49-year-old primiparous woman presenting with syncope and intense bleeding from an anterior vaginal lesion, 3 weeks after uterine evacuation for a presumed spontaneous abortion. A vaginal metastatic nodule was suspected; haemostasis was achieved with vaginal packing, precluding the need for surgical intervention. The patient was ultimately diagnosed with invasive mole with vaginal and lung metastases (stage III high-risk gestational trophoblastic neoplasia (GTN)) and started on multiple-agent chemotherapy. Two months later the lesion had regressed completely, and remission was reached 2 weeks later. Clinicians should consider the possibility of metastatic GTN with vaginal involvement whenever heavy vaginal bleeding follows a recent history of failed pregnancy.

Subsequent Pregnancy Experience in Patients With Gestational Trophoblastic Disease

1994 ◽  
Vol 49 (8) ◽  
pp. 544-545 ◽  
Author(s):  
Ross S. Berkowitz ◽  
Marilyn R. Bernstein ◽  
Olivier Laborde ◽  
Donald P. Goldstein
Keyword(s):  
Gestational Trophoblastic Disease ◽  
Subsequent Pregnancy ◽  
Trophoblastic Disease

Spectrum of Pathological Lesions in Uterine Specimens with Focus on Gestational Trophoblastic Disease in Karachi

2020 ◽  
Keyword(s):  
Hydatidiform Mole ◽  
Endometrial Stromal Sarcoma ◽  
Gestational Trophoblastic Disease ◽  
Cross Sectional Study ◽  
Reproductive Age ◽  
P Value ◽  
Cross Sectional ◽  
Endometrial Polyps ◽  
Trophoblastic Disease ◽  
Proliferative Endometrium

Background: The most common benign pathological lesion in women of reproductive age is uterine leiomyoma. Gestational trophoblastic disease includes tumors and tumor like lesions originating from trophoblastic tissue. The aim of this study was to find the spectrum of molar pregnancy and uterine pathologies focusing on gestational trophoblastic disease as no study has been done in the past few years. Methods: Endometrial and uterine specimens of patients (n=436) between the ages of 15-65 years were collected from a private hospital in Karachi from December 2018 to December 2019. This cross-sectional study was carried out by pathological diagnosis of patients’ samples under light microscopy using hematoxylin and eosin staining. Stratification was done about age and nature of specimen to control the effect modifiers. The post stratification Chi square test was applied and p value <0.05 was considered significant. Results: Mean age of the patients was 36.1 years ±7.8. Total 436 uterine biopsies included 260(59.6%) hysterectomies, 56(12.8%) endometrial curetting’s, 117(26.8%) evacuation specimens and 3(0.7%) polypectomies. Common pathologies included 124(28.4%) leiomyomas, 61(14%) proliferative endometrium, 52(11.9%) adenomyosis and 32(7.3%) endometrial polyps. Gestational trophoblastic disease was seen in 9(2.06%). Seven (87.5%) were partial hydatidiform moles, one (12.5%) exaggerated placental site reaction and one choriocarcinoma. Mole was common between 26-30 years with mean age of 27.2 years and prevalence was 6/100 abortions. Conclusion: Leiomyoma was the commonest (28.4%) uterine pathology followed by proliferative endometrium (14.5%). However, endometrial stromal sarcoma and endometriosis were found 0.2% each. High prevalence of mole was seen in this study. Partial mole was most common and choriocarcinoma was least common. Keywords: Hydatidiform Mole; Pathology; Prevalence.

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