绒癌和侵蚀性葡萄胎患者化疗后一年内妊娠结局的分析

Pregnancy of Patients Conceived within One Year after Chemotherapy for Gestational Trophoblastic Tumor

目的 探讨绒癌和侵蚀性葡萄胎患者多疗程化学治疗（ 化疗） 后，１ 年内妊娠的结局。方法 分析绒癌和侵蚀性葡萄胎患者化疗后在１ 年内妊娠的２２ 例发生异常妊娠、废胎率的情况及其与化疗停药的间隔的关系。结果 ２２ 例中，足月分娩９ 例，废胎６ 例，废胎率为２７．３％ 。其中停止化疗半年内妊娠者废胎率高于半年以上者（ Ｐ＜ ０．０５）。患者发生产后绒癌１ 例，发生重复性葡萄胎１ 例，此２ 例均发生在停药５ 个月内妊娠。结论 绒癌和侵蚀性葡萄胎经化疗保留子宫是可行的。但多疗程化疗后，妊娠不宜太早，应至少避孕半年，最好避孕１ 年。

Objective To explore the risk of pregnancy in patients conceived within one year after successful chemotherapy for gestational trophoblastic tumor. Methods 22 patients conceived within one year after chemotherapy were followed up and analysed about abnormal pregnant result, wastage rate and the time of interval between chemotherapy and pregnancy. Results Among 22 cases,9 cases were full term birth,6 cases were wastage. The wastage rate was 27.3%. The wastage rate of these patients conceived within half a year was higher than one year ( P <0.05).1 repeated hydatidiform mole and one post term choriocarcinoma occurred in 22 patients. They both were conceived within 5 months after chemotherapy. Conclusions Preservation of fertility is feasible in patients suffering from choriocarcimona and invasive mole. But these patients should practise contraception at least half a year after chemotherapy, and it's better to advise patients to take contraception for one year.