Fertility-sparing surgery, with subsequent pregnancy, in persistent gestational trophoblastic neoplasia

Gestational trophoblastic neoplasia (GTN) is primarily a disease of women o f reproductive age. In most instances, it is cured by surgical evacuation o f the uterus, with persistent disease being very sensitive to chemotherapy. Hysterectomy, recommended for persistent chemotherapy-resistant uterine di sease, may be unacceptable to the woman who wishes to maintain her fertilit y. Uterine resection of localized disease, with uterine reconstruction, may be a viable alternative. A case is presented of a woman with persistent ut erine GTN, treated with localized uterine resection and reconstruction, fol lowed by two successful pregnancies and deliveries. The literature is revie wed and potential pregnancy complications of this management, particularly uterine rupture, are discussed.