Pregnancy Outcomes After Chemotherapy For Gestational Trophoblast Neoplasia
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Abstract
Objective: To find the outcomes of pregnancy in women who conceived after chemotherapy & to establish the safety of chemotherapeutic regimen used for the treatment of GTN in women of reproductive age.
Materials & Methods: Prospective cohort Follow up study done at Department of obstetrics & gynaecology, Hayatabad Medical Complex, Peshawar, Pakistan. 90 women with the diagnosis of GTN were hospitalized & treated according to standard chemotherapeutic regimens between june 2005-2014, they were followed up for a period of five years. Patients demographic profile, FIGO score, type of chemotherapy, treatment & pregnancy outcomes were recorded on predesigned performa and computerized record was kept. Data analysis done through SPSS 16.
Results: In 90 patients diagnosed with GTN, 59(65.6%) patients were low risk and 31(34.4 %) were in high risk category . Overall survival was 100% in low risk category and 70.58% in high risk category.
9 women conceived during first year of follow up while 35 conceived afterwards.
44 patients conceived with 38(86.3%) having live term births without congenital abnormalities.
5 women had miscarriage,1 had repeat molar pregnancy, while 4 women experienced live twin birth after chemotherapy for GTN.
Conclusions: Current chemotherapeutic regimens used in treatment of gestational trophoblast neoplasia are highly effective, safe & preserves fertility. Women should expect normal reproductive outcomes similar to general population after treatment of gestational trophoblast neoplasia.
Key words: Gestational Trophoblast Neoplasia(GTN), FIGO Prognostic score (International federation of Gynaecologist& Obstetrician) ,Mortality, Chemotherapy
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