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Severe uterine haemorrhagic complications from gestational trophoblastic neoplasia.
Severe uterine haemorrhagic complications from gestational trophoblastic neoplasia.
- Source :
-
European Journal of Obstetrics & Gynecology & Reproductive Biology . Jan2025, Vol. 304, p30-34. 5p. - Publication Year :
- 2025
-
Abstract
- • This study included 2099 cases of gestational trophoblastic tumours. • Of 38 uterine haemorrhagic complications, 17 patients presented with potentially life-threatening uterine rupture. • This is a rare yet serious event; specific mortality remains low at approximately 3%. • Fertility-sparing techniques are feasible, with five cases of pregnancy reported. • Deep myometrial or serosal invasion: a predictive factor for haemorrhagic complication? Gestational trophoblastic neoplasia are highly vascularized infiltrating lesions that can lead to severe haemorrhagic complications. The aim of this study was to describe the characteristics of patients with gestational trophoblastic neoplasia who experienced uterine haemorrhagic complications, and their management. This retrospective study analysed the histories of 2099 patients with gestational trophoblastic neoplasia registered at the French Reference Centre for Trophoblastic Disease between 1999 and 2023. Among 2099 patients with a confirmed diagnosis of gestational trophoblastic neoplasia, 38 patients who experienced uterine haemorrhagic complications requiring interventional treatment were identified. Among them, 23 (61%) had a low-risk tumour and 15 (39%) had a high-risk tumour according to their International Federation of Gynecology and Obstetrics score. Twenty (53%) patients experienced haemoperitoneum and 18 (47%) patients experienced massive vaginal bleeding. Seventeen (45%) patients experienced uterine rupture. Haemorrhagic treatment consisted of surgery for 26 (70%) patients, exclusive uterine embolization for six (16%) patients, embolization followed by surgery for four (11%) patients, and embolization after failure to control bleeding by aspiration for one (3%) patient. Of the five deaths (13%), one (3%) was related to the uterine haemorrhagic complication. Three of 15 (20%) patients treated conservatively reported subsequent pregnancies. There are no established guidelines for managing severe uterine haemorrhagic complications. The availability of interventional radiology resources could allow for increased use of fertility-preserving procedures, with encouraging results regarding subsequent pregnancies. [ABSTRACT FROM AUTHOR]
Details
- Language :
- English
- ISSN :
- 03012115
- Volume :
- 304
- Database :
- Academic Search Index
- Journal :
- European Journal of Obstetrics & Gynecology & Reproductive Biology
- Publication Type :
- Academic Journal
- Accession number :
- 181512839
- Full Text :
- https://doi.org/10.1016/j.ejogrb.2024.11.016