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KMID : 0378019820250110097
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New Medical Journal
1982 Volume.25 No. 11 p.97 ~ p.104
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A Clinical Study of Prophylactic Chemotherapy in Molar Pregnancy
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Abstract
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This report deals with 124 patients with primary hydatidiform moles studies during 4 1/2 years (from Jan. 1978 to June 1982) at the Department of Obstetrics and Gynecology, Seoul National University Hospital.
Of the 124 patients with molar pregnancy, blind random sampling was done to study the efficacy of prophylactic chemotherapy in _preventing malignant disease. Among 81 patients, the control group without prophylactic chemotherapy was 29 patients and with prophylactic chemotherapy group was 52 patients.
Several drugs (MTX, Actinomycin-D) was administered by various routes to 52 patients at the time of evacuation. Proliferative sequelae occurred in 7 patients (13.5%) in the treated group in contrast to 7 patients (24. 1%) in the control group. Three cases (5. 8%) ~of metastatic trophoblastic disease were encountered in the treated group, but three cases (10%) of metastatic trophoblastic disease developed in untreated group.
Drug induced toxicity in the treated group was mild and transient. Safe methods of evacuation are suction curettage and abdominal hysterectomy. Time -interval for normal involution is various at each gestational age.
Despite the safety and effectiveness of prophylactic chemotherapy, its use should be limited to special situations such as high risk pregnancy. But the risk of developing trophoblastic disease is greater than any other countries and since adequate gonadotropin follow up is unavailable, the use of prophylactic chemotherapy may be advantageous in Korea.
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KEYWORD
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