Outcome of pregnancies occurring before completion of human chorionic gonadotropin follow-up in patients with persistent gestational trophoblastic tumor

Objective. To determine the outcome of pregnancies occurring before complet ion of human chorionic gonadotropin follow-up in patients treated with chem otherapy for gestational trophoblastic tumor. Methods, Retrospective record review of patients with gestational trophobla stic tumor who conceived before standard hCG follow-up was completed during 1973-1998, Results. Forty-three patients treated for gestational trophoblastic tumors conceived before human chorionic gonadotropin follow-up was completed, The antecedent pregnancy was complete mole in 31 (72.1%) and partial mole in 12 (27.9%) patients. Of the 43 patients, 39 (90.7%) had stage I, 1 had stage II, and 3 had stage III disease. The mean interval from human chorionic gon adotropin remission to new pregnancy was 6.3 months (range 1-11 months), Te n patients underwent elective termination and four patients were lost to fo llow-up. Of the remaining 29 patients, 22 (75.9%) had term live births, 3 ( 10.3%) had preterm delivery, 3 had spontaneous abortion, and 1 (3.5%) had a repeat mole. Two cases of fetal anomalies were detected; one was inherited polydactyly and the other was hydronephrosis, One patient developed chorio carcinoma with lung involvement and underwent cesarean section at 28 weeks; a normal fetus was delivered and no choriocarcinoma was detected in the pl acenta. Conclusion, Pregnancies occurring in patients treated for gestational troph oblastic tumor before standard human chorionic gonadotropin follow-up is co mpleted may continue under close clinical surveillance since the majority h ave a favorable outcome. However, patients should also be advised of the lo w but important risk of delayed diagnosis in case tumor relapse develops du ring early subsequent pregnancy. (C) 1999 Academic Press.