Gestational trophoblastic neoplasia: a prospective study of pregnancy outcome following successful chemotherapy

Author(s): Guhan Beena*, Lakshmi S., Rajmohan Laxmy

Abstract

Gestational Trophoblastic Neoplasia (GTN) is the only neoplasia that is really curable and patients can preserve fertility with different medical and surgical treatment modalities. The aim of this study was to explore the conception rates and the outcome of pregnancy after successful chemotherapy for GTN. Between January 1998 to December 2008, 199 patients who went in for GTN were all treated with chemotherapy depending on the risk scoring. Medical records were analyzed retrospectively for the time interval between completion of chemotherapy and pregnancy, conception rate and the pregnancy outcome. 176 (94.1%) had subsequent conceptions, 8 (4.2%) had secondary infertility and 3 (1.6%) adopted contraception for the fear of the side effects of chemotherapy on their babies.12 were lost for follow up. 58 (33%) of the pregnancies happened within one year and 118 (67%) after one year. Majority of the subsequent conceptions resulted in term live birth 147 (83.6%). Of the remaining pregnancies, 5 (2.8%) went in for preterm delivery, 22 (12.5 %) ended up in abortion and 2 (1.1%) unfortunately turned out to be molar pregnancy again. No anomalies were reported from our study group. Outcome was almost similar in those who conceived within one year and beyond. 123 (70%) had a normal vaginal delivery and 53 (30%) needed caesarian section. Majority of the neonates were females 102 (58%) and 118 (67%) had a birthweight of 2.5-3 Kg. Our study indicates that patients who do conceive following chemotherapy for GTN and are desperate to have a child can definitely be assured of a promising reproductive future which is comparable to the general population.

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