A Clinical Study on Gestational Trophoblastic Disease.
- Author:
Sung Won LEE
- Publication Type:Original Article
- Keywords:
gestational trophoblastic disease
- MeSH:
Abortion, Induced;
Abortion, Spontaneous;
Drug Therapy;
Female;
Gestational Age;
Gestational Trophoblastic Disease*;
Gravitation;
Hospital Records;
Humans;
Hydatidiform Mole;
Hysterectomy;
Incidence;
Lutein;
Parity;
Pre-Eclampsia;
Pregnancy;
Retrospective Studies;
Trophoblastic Neoplasms
- From:Korean Journal of Gynecologic Oncology and Colposcopy
1999;10(4):358-367
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
This study is designed to evaluate the clinical characteristics and the outcomes of the management of gestational trophoblastic disease diagnosed at our hospital. With a retrospective review of hospital record from 1989 to 1998, we analysed 54 cases of gestational trophoblastic disease by the clinical characteristics and the outcomes of management. The results are as follows 1. The incidence of the gestational trophoblastic disease compared with delivery is one per 341 deliveries and is decreasing with time(from one per 252 deliveries at 1989 to one per 694 deliveries at 1998). 2. The most frequent age is 20-29 years old(61,1%). 3, The most frequent gravity and parity is 0-2 times(68.5%) and 0-1 time(79.6%) respectively. 4. The symptoms and signs are amenorrhea(94.4%), vaginal bleeding(74,1%), abdominal pain( 33.3%), hyperemesis gravidarum(25.9%), excessive uterine enlargement(24.1%), anemia(18.5%), hyperthyroidism(7.4%), theca lutein ovarian cyst(3.7%), and preeclampsia (1.9%). 5. We divided the patients by the uterine size for gestational age; large for date 50%, normal for date 44.4%, and small for date 5.6%. 6. The antecedent pregnancies of patients with persistent gestational trophoblastic tumor are hydatidiform mole 87.5%, abortion 12.5% in middle risk group and hydatidiform mole 66.7%, term pregnancy 22.2%, abortion 11,1% in high risk group. 7. We divided the patients with persistent gestational trophoblastic tumor by the FIGO staging system; stage I 70.6%, stage II 5.9%, stage III 11.8%, stage IV 11,8%. 8. The regimens of treatment are consisted of D & E only(59.3%), D & E with prophylactic chemotherapy(9.3%), D & E with chemotherapy(25.9%), and D & E with chemotherapy and hysterectomy(5.6%). Complete remissions are shown in 100% of D & E only and D & E with prophylactic chemotherapy, in 85.7% of D & E with chemotherapy, and in 33.3% of D & E with chemotherapy and hysterectomy. Dividing the patients with persistent gestational trophoblastic tumor by the WHO prognostic scoring system, complete remissions are shown in 75% of middle risk group and in 77.8% of high risk group. 9. The duration of chemotherapy for complete remission is 2.5 cycles & 77.5 days in middle risk group and 4 cycles & 130.1 days in high risk group. 10. The subsequent pregnancies after complete remission of gestational trophoblastic disease are term delivery 81%, spontaneous abortion 9.5%, induced abortion 4.8%, and preterm delivery 4.8%.
