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Volume 4, Issue 3 (Summer 2019)                   J Obstet Gynecol Cancer Res 2019, 4(3): 111-116 | Back to browse issues page

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Aminimoghaddam S, Ahmad A, Nassiri S. The Association of Gestational Trophoblastic Neoplasia and Misoprostol Administered Before Suction Curettage of Molar Pregnancy. J Obstet Gynecol Cancer Res 2019; 4 (3) :111-116
URL: http://jogcr.com/article-1-243-en.html
1- Associated Professor, Department of Gynecology, Faculty of Medicine, Iran University of medical sciences, Tehran, Iran
2- Assistant Professor, Iran University of Medical Sciences, Tehran, Iran
3- Assistant Professor, Department of Gynecology, Faculty of Medicine, Iran University of medical sciences, Tehran, Iran , setare_n99@yahoo.com
Abstract:   (2636 Views)

Background & Objective: Gestational trophoblastic neoplasia contains a group of abnormal trophoblastic tumors including hydatidiform moles (partial and complete) and non-molar trophoblastic neoplasms (invasive mole, choriocarcinoma, placental site trophoblastic tumor). The incidence is 1-2 per 1000 deliveries both in the United States and Europe. The aim of this study was to prove the noninferiuority and safety of misoprostol use in cervical ripening in patient with molar pregnancy.
Materials & Methods: This retrospective cohort study was performed on 150 women with molar pregnancy referred to Firuzgar and Mirza-koochack-khan hospitals in Tehran, between 2006 and 2013. We defined group 1 as 100 patients without Misoprostol pretreatment and group 2 as 50 patients with Misoprostol pretreatment. There was no significant difference in the number of complete or partial mole between the two groups. They were followed by serum ß-hCG level and if it became plateaued in 4 measurements or rose more than 10% in 3 measurements in a period of three weeks, would be defined as persistent.
Results: We found no significant difference of maternal age, fundal height, gestational age, gravity, parity, number of previous abortions and prevalence of complete and partial moles between the two groups. A total of 27 (27%) patients in non-Misoprostol group and 5 (10%) patients in Misoprostol group developed Persistent GTN (P<0.05). We observed no case of trophoblastic embolism in the misoprostol group.
Conclusion:  Misoprostol cervical ripening resulted in lower Persistent GTN incidence. Also, trophoblastic embolism following misoprostol administration is so rare that we observed no case.

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Systematic Review: Original Research | Subject: Gynecology Oncology
Received: 2019/03/20 | Accepted: 2019/07/28 | Published: 2019/09/27

1. Afolabi BB, Oyeneyin OL, Ogedengbe OK. Intravaginal misoprostol versus Foley catheter for cervical ripening and induction of labor. International Journal of Gynecology & Obstetrics. 2005 Jun;89(3):263-7. [DOI:10.1016/j.ijgo.2005.02.010] [PMID]
2. Berkowitz RS, Goldstein DP. Gestational trophoblastic disease. Cancer. 1995 Nov 15;76(S10):2079-85. https://doi.org/10.1002/1097-0142(19951115)76:10+<2079::AID-CNCR2820761329>3.0.CO;2-O [DOI:10.1002/1097-0142(19951115)76:10+3.0.CO;2-O]
3. Wing DA, Gaffaney CA. Vaginal misoprostol administration for cervical ripening and labor induction. Clin Obstet Gynecol. 2006 Sep; 49(3):627-41. [DOI:10.1097/00003081-200609000-00021] [PMID] [DOI:10.1097/00003081-200609000-00021] [PMID]
4. Gelber S, Sciscione A. Mechanical methods of cervical ripening and labor induction. Clin Obstet Gynecol. ٢٠٠٦ Sep; 49(3):642-57. [DOI:10.1097/00003081-200609000-00022] [PMID] [DOI:10.1097/00003081-200609000-00022] [PMID]
5. Shepherd JH, Knuppel RA.The role of prostaglandins in ripening the cervix and inducing labor. Clin Perinatol. 1981 Feb; 8(1):49-62. [DOI:10.1016/S0095-5108(18)31094-7] [DOI:10.1016/S0095-5108(18)31094-7]
6. Hofmeyr GJ, Gulmezoglu AM. Vaginal misoprostol for cervical ripening and induction of labour. Cochrane Database of Sys Rev. 2003;(1):CD000941. [DOI:10.1002/14651858.CD000941] [PMCID] [DOI:10.1002/14651858.CD000941] [PMCID]
7. Ghosh A1, Lattey KR2, Kelly AJ1. Nitric oxide donors for cervical ripening and induction of labour. Cochrane Database Syst Rev. 2016 Dec 5;12:CD006901. [DOI:10.1002/14651858.CD006901.pub3] [PMID] [PMCID]
8. Gibbs RS, Karlan BY, Haney AF, Nygaard IE. Danforth's obstetrics and gynecology. Philadelphia, PA: Lippincott Williams & Wilkins; 2008 Apr 23
9. Keirse MJ. Termination of molar pregnancy by intramuscular administration of ١٥(S)-١٥-methyl-prostaglandin F٢ alpha. Prostaglandins Med. 1980 May;4(5): 333-9. [DOI:10.1016/0161-4630(80)90007-5] [DOI:10.1016/0161-4630(80)90007-5]
10. Fischer Z, Chwalisz K, Michałkiewicz W. Termination of normal and pathologicalpregnancy with Sulprostone. Acta Chir Hung. 1986;27(3):151- 6.
11. Chow PK. Partial Hydatidiform Mole in a Medical Abortion with the Mifepristone/ Misoprostol Combination.Taiwanese Journal of Obstetrics and Gynecology 2004; 43 (4): 233-234 [DOI:10.1016/S1028-4559(09)60094-2]
12. 12- T. Y. Ng, lc wong diagnosis and management of gestational trophoblasticneo plasia ,Best practice& research. clinical obstetrics & Gynecology, Nov 2003, 17(6): 893-903. [DOI:10.1016/S1028-4559(09)60094-2] [DOI:10.1016/S1028-4559(09)60094-2]
13. James S, Epidimiology of gestational trophoblastic diseases, Best practice & Research. Clinical obstetrics & Gynecology, February (2004), 18(1): A2 - A9.
14. Bugti Q, Baloch N, Baloch M, gestational trophoblastic diseases in Quetta, Pakistan J. Med. Res, 2005،44 (2): 92-
15. Altman AD, BentleyB, MurrayS, et al, Maternal age related rates of gestationatrophoblastic disease, obstet gynecol, 2008, 112(2pt1): 224-50. 83 [DOI:10.1097/AOG.0b013e3181802186] [PMID] [DOI:10.1097/AOG.0b013e3181802186] [PMID]
16. Altier A, Franceschi s, Ferlay j, Epidemiology and aetiology of gestational trophoblastic disease, the lancet oncology,nov 2003, 4(11): 670- 678. [DOI:10.1016/S1470-2045(03)01245-2] [DOI:10.1016/S1470-2045(03)01245-2]
17. Gemzell-Danielsson KC, Fiala C, Weeks A. Misoprostol: first-line therapy for incomplete miscarriage in the developing world. BJOG 2007;114:1337-9. [DOI:10.1111/j.1471-0528.2007.01491.x] [PMID] [DOI:10.1111/j.1471-0528.2007.01491.x] [PMID]
18. Phupong V, Taneepanichskul S, Kriengsinyot R, Sriyirojana N, Blanchard K, Winikoff B. Comparative study between single dose 600 microg and repeated dose of oral misoprostol for treatment of incomplete abortion. Contraception 2004;70:307-11 [DOI:10.1016/j.contraception.2004.04.002] [PMID] [DOI:10.1016/j.contraception.2004.04.002] [PMID]
19. Blum J, Winikoff B, Gemzell-Danielsson K, Ho PC, Schiavon R, Weeks A. Treatment of incomplete abortion and miscarriage with misoprostol. Int J Gynaecol Obstet 2007;99 (Suppl 2):S186-9. [DOI:10.1016/j.ijgo.2007.09.009] [PMID] [DOI:10.1016/j.ijgo.2007.09.009] [PMID]
20. Dickinson JE, Evans SF. The optimization of intravaginal misoprostol dosing schedules in second-trimester pregnancy termination. Am J Obstet Gynecol 2002;186:470-4. [DOI:10.1067/mob.2002.121085] [PMID] [DOI:10.1067/mob.2002.121085] [PMID]
21. Noor N, Ansari M, Ali SM, Parveen S. Foley catheter versus vaginal misoprostol for labour induction. International journal of reproductive medicine. 2015;2015. [DOI:10.1155/2015/845735] [PMID] [PMCID] [DOI:10.1155/2015/845735] [PMID] [PMCID]
22. Jozwiak M, ten Eikelder M, Oude RK, de Groot C, Feitsma H, Spaanderman M, van Pampus M, de Leeuw JW, Mol BW, Bloemenkamp K. Foley catheter versus vaginal misoprostol: randomized controlled trial (PROBAAT-M study) and systematic review and meta-analysis of literature. American journal of perinatology. 2014 Feb;31(2):145-56. [DOI:10.1055/s-0033-1341573] [PMID] [DOI:10.1055/s-0033-1341573] [PMID]
23. Chen W, Xue J, Gaudet L, Walker M, Wen SW. Meta-analysis of Foley catheter plus misoprostol versus misoprostol alone for cervical ripening. International Journal of Gynecology & Obstetrics. 2015 Jun 30;129(3):193-8. [DOI:10.1016/j.ijgo.2015.01.005] [PMID] [DOI:10.1016/j.ijgo.2015.01.005] [PMID]

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