Ten-Year Experience with the Conservative Management of Abnormally Invasive, Residual Trophoblastic Disease. A Retrospective Case Series.
الكلمات الدالة
نبذة مختصرة
Conservative management of abnormally invasive, residual trophoblastic disease (AIRTD) is underreported. We aimed at critically reviewing our experience with such conservative management. We conducted a retrospective cohort study that included 24 women. The median completed week of gestation at delivery (20/24, 83.3%)/2nd trimester miscarriage (4/24, 16.7%) was 35 (range 17-41). Two women initially chose a surgical treatment (dilatation and curettage), but AIRTD remained sonographically visible afterward. Five patients developed a fever >38.0°C for ≥2 days (5/24, 20.8%). Due to heavy vaginal bleeding, 2 patients then underwent dilatation, diagnostic hysteroscopy, and curettage (2/24, 8.3%). One of these women also had to undergo hysterectomy (1/24, 4.2%). The 23 patients without hysterectomy underwent regular sonographic follow-up examinations. Regression of AIRTD was found after a median of 74 days (range 36-323). In conclusion, our data suggest that a conservative, observational treatment is feasible in AIRTD, with low rates of secondary surgical interventions. The long time intervals until regression require perseverance by these patients.