妊娠滋养细胞疾病与“二胎”妊娠

Gestational trophoblastic disease and the second-birth pregnancy

随着"二胎"政策全面实施,瘢痕子宫、高龄产妇带来了很多妇科和产科的难题。在重视和应对产科挑战的同时,我们应该同样重视"二胎"妊娠带来的妇科问题,其中葡萄胎发病率升高,可能继发妊娠滋养细胞肿瘤,及妊娠滋养细胞肿瘤患者治疗后的二胎问题,都是目前关注的热点。本文围绕妊娠滋养细胞疾病与"二胎"妊娠的问题,阐述了年龄与妊娠滋养细胞疾病发生发展的关系,化疗对妊娠滋养细胞肿瘤患者卵巢功能的影响,化疗过程中卵巢功能的保护,及治疗后再次妊娠的时机及预后等问题。

With the overall implementation of the two-child policy, scar of the uterus and elderly mothers bring a lot of gynecological and obstetric problems. Therefore, we are paying attention and making responses to obstetric challenges. At the same time, we should also attach importance to the gynecological problems caused by the second- birth pregnancy. Currently, the hot spots include increased incidence of hydatidiform mole, which may lead to gestational trophoblastic tumor, and the second-birth pregnancy of gestational trophoblastic tumor patients after treatment. This paper discusses the issues of gestational trophoblastic disease and the second-birth pregnancy from the following aspects： relationship between age and development of gestational trophoblastic disease, effect of chemotherapy on ovarian function in gestational trophoblastic tumor patients, protection of ovarian function during chemotherapy, and appropriate time and prognosis of next pregnancy after treatment.