title: Pregnancy outcomes after chemotherapy for trophoblastic neoplasia.
abstract: BACKGROUND
  The successful development of chemotherapy enabled a fertilitysparing treatment for patients with trophoblastic neoplasia. After disease remission, the outcome of a subsequent pregnancy becomes a great concern for these women.
  
  
  OBJECTIVE
  To analyze existing studies in the literature that describe the reproductive outcomes of patients with trophoblastic neoplasia treated with chemotherapy.
  
  
  METHODS
  Systematic review was performed searching for articles on Medline/ Pubmed, Lilacs and Cochrane Library databases, using the terms "gestational trophoblastic disease" and "pregnancy outcome".
  
  
  RESULTS
  A total of 18 articles were included. No evidence of decreased fertility after chemotherapy for trophoblastic neoplasia was observed. The abortion rates in patients who conceived within 6 months after chemotherapy was higher compared to those who waited longer. Some studies showed increased rates of stillbirth and repeat hydatidiform moles. Only one work showed increased congenital abnormalities.
  
  
  CONCLUSIONS
  The pregnancies conceived after chemotherapy for trophoblastic neoplasia should be followed with clinical surveillance due to higher rates of some pregnancy complications. However, studies in the literature provide reassuring data about reproductive outcomes of these patients.
authors.affiliation: Division of Obstetrics, Department of Gynecology and Obstetrics, Faculdade de Medicina da Universidade de São Paulo (FMUSP), São Paulo, SP, Brazil.
authors.forename: Mila Trementosa
authors.initials: MT
authors.lastname: Garcia
authors.affiliation: Division of Obstetrics, Department of Gynecology and Obstetrics, Faculdade de Medicina da Universidade de São Paulo (FMUSP), São Paulo, SP, Brazil.
authors.forename: Lawrence Hsu
authors.initials: LH
authors.lastname: Lin
authors.affiliation: Division of Obstetrics, Department of Gynecology and Obstetrics, Faculdade de Medicina da Universidade de São Paulo (FMUSP), São Paulo, SP, Brazil.
authors.forename: Koji
authors.initials: K
authors.lastname: Fushida
authors.affiliation: Division of Obstetrics, Department of Gynecology and Obstetrics, Faculdade de Medicina da Universidade de São Paulo (FMUSP), São Paulo, SP, Brazil.
authors.forename: Rossana Pulcineli Vieira
authors.initials: RP
authors.lastname: Francisco
authors.affiliation: Division of Obstetrics, Department of Gynecology and Obstetrics, Faculdade de Medicina da Universidade de São Paulo (FMUSP), São Paulo, SP, Brazil.
authors.forename: Marcelo
authors.initials: M
authors.lastname: Zugaib
mesh_terms: D000022:Abortion, Spontaneous / Q000139:chemically induced; D000970:Antineoplastic Agents / Q000009:adverse effects*; D005260:Female; D005298:Fertility / Q000187:drug effects*; D031901:Gestational Trophoblastic Disease / Q000150:complications / Q000188:drug therapy*; D006801:Humans; D011247:Pregnancy; D011256:Pregnancy Outcome; D061685:Time-to-Pregnancy
chemical_list: D000970:Antineoplastic Agents