Pregnancy after chemotherapy for trophoblastic diseases and psychosomatic development in the progeny

We treated 542 patients with trophoblastic diseases from 1965 through 1988, and succeeded in preserving fertility in 269 of them (240 cases of invasive mole and 29 cases of choriocarcinoma). Of the 269 patients, 198 (79.5%) conceived after completing treatment. A total of 396 pregnancies in these women resulted in 295 term live births (74.5%), 51 spontaneous abortions (12.9%), and 4 recurrences of moles (1.0%). Four cases (1.32%) of malformations were discovered. The growth conditions of 101 children born in 1976 or later were followed up until the age of 18 months. Their heights or weights did not differ significantly from those of children measured in national infantile-growth surveys. The psychoneurological development of 54 children up to the age of 7 years who were studied by using infantile mental-development questionnaires showed no marked mental retardation. Our results provide strong evidence of the safety of chemotherapy for the treatment of trophoblastic diseases.