Second Uterine Curettage and the Number of Chemotherapy Courses in Postmolar Gestational Trophoblastic Neoplasia: A Randomized Controlled Trial.


OBJECTIVE:To investigate the effect of second uterine curettage on the number of chemotherapy courses and relapse rate in low-risk postmolar gestational trophoblastic neoplasia. METHODS:In a phase III trial, patients with low risk gestational trophoblastic neoplasia were randomised (1:1) to a second curettage or no curettage group before methotrexate treatment. Eligibility criteria were serum human chorionic gonadotropin (hCG) level 5,000 international units/L or less and fit for treatment with methotrexate. Exclusion criteria were previous uterine perforation and life-threatening bleeding. With a two-sided 5% significance level and a power of 99%, a sample size of 44 patients per group was necessary to detect a mean reduction in 2.3 chemotherapy courses. The primary outcome was the number of chemotherapy courses required for hCG normalization. Secondary outcomes were needed for second-line treatment, toxicity, relapse rates, and variables associated with number of chemotherapy courses. RESULTS:From October 2011 through February 2016, 89 patients entered the study at the Mansoura Trophoblastic Clinic; in each group, 43 patients were included in the intention-to-treat analyses. Surgical complications did not occur. The mean number of chemotherapy courses required to reach hCG normalization was 4.4±2.2 SD in the control group vs 3.8±2.3 SD in the intervention group (P=.14). Groups were comparable in terms of second-line treatment needed to reach hCG normalization, and relapse within the first year. Only hCG levels related to the number of chemotherapy cycles required for hCG normalization. CONCLUSION:Second uterine curettage did not reduce the number of chemotherapy courses required or affect relapse rate in patients with low-risk postmolar gestational trophoblastic neoplasia. CLINICAL TRIALS REGISTRATION:Dutch Trial Registry, NTR3390.


Obstet Gynecol


Hemida R,Vos EL,El-Deek B,Arafa M,Toson E,Burger CW,van Doorn HC




Has Abstract


2019-05-01 00:00:00












  • Carcinoma of the vulva: analysis of treatment and survival.

    abstract::The treatment of 224 patients with invasive squamous cell carcinoma of the vulva over a 20-year interval at the Mayo Clinic resulted in an overall survival rate of 75%, compared with 89% for age-matched controls. For patients with stage I disease, 5-year survival was 90%; for those with stages II, III, and IV, it was ...

    journal_title:Obstetrics and gynecology

    pub_type: 杂志文章


    authors: Podratz KC,Symmonds RE,Taylor WF,Williams TJ

    更新日期:1983-01-01 00:00:00

  • Bromocriptine mesylate (Parlodel) in the management of amenorrhea/galactorrhea associated with hyperprolactinemia.

    abstract::The efficacy and safety of bromocriptine mesylate (5 to 7.5 mg per day for up to 24 weeks) were studied in 22 clinical trials involving 226 patients who had amenorrhea/galactorrhea associated with hyperprolactinemia and no demonstrable pituitary tumor. Of the 187 patients evaluated for efficacy, 80% experienced reinit...

    journal_title:Obstetrics and gynecology

    pub_type: 临床试验,杂志文章


    authors: Cuellar FG

    更新日期:1980-03-01 00:00:00

  • Comparison of bone density in amenorrheic women due to athletics, weight loss, and premature menopause.

    abstract::Studied was the peripheral bone density of 39 women (ages 18 to 43) with the diagnosis of secondary amenorrhea in an effort to define the population of amenorrheic women at risk for osteoporosis. Eight women had exercise-induced amenorrhea (athletes), 20 women had amenorrhea associated with weight loss, and 11 women h...

    journal_title:Obstetrics and gynecology

    pub_type: 杂志文章


    authors: Jones KP,Ravnikar VA,Tulchinsky D,Schiff I

    更新日期:1985-07-01 00:00:00

  • An outcomes management program in gynecologic oncology.

    abstract:OBJECTIVE:To evaluate the effectiveness of an outcomes-management program designed to provide high-quality patient care, generate data for outcomes research, and decrease costs in a managed-care environment. METHODS:An outcomes-management program was launched in June 1994, based on the elimination of wasteful or ineff...

    journal_title:Obstetrics and gynecology

    pub_type: 杂志文章


    authors: Morris M,Levenback C,Burke TW,Dejesus Y,Lucas KR,Gershenson DM

    更新日期:1997-04-01 00:00:00

  • Cervical adenosquamous carcinoma: tumor implantation in an episiotomy scar.

    abstract:BACKGROUND:We report a rare case of a cervical adenosquamous carcinoma, initially diagnosed during delivery, with subsequent implantation in the episiotomy scar 5 weeks postpartum. CASE:A 35-year-old woman with cervical adenosquamous carcinoma diagnosed during delivery was treated with radical abdominal hysterectomy w...

    journal_title:Obstetrics and gynecology

    pub_type: 杂志文章


    authors: Neumann G,Rasmussen KL,Petersen LK

    更新日期:2007-08-01 00:00:00

  • Learning curve in ultrasonographic screening for selected fetal structural anomalies in early pregnancy.

    abstract:OBJECTIVE:To assess the value of first trimester screening by ultrasonography in detecting structural anomalies of the fetus in a general obstetric population. METHODS:During 1993-1998, 20,465 consecutive pregnant women who resided in a defined geographic area participated in ultrasonographic screening for major malfo...

    journal_title:Obstetrics and gynecology

    pub_type: 杂志文章


    authors: Taipale P,Ammälä M,Salonen R,Hiilesmaa V

    更新日期:2003-02-01 00:00:00

  • ACOG committee opinion number 398, February 2008: fatigue and patient safety.

    abstract::It has long been recognized that fatigue can affect human cognitive and physical function. Although there are limited published data on the effects of fatigue on health care providers, including full-time practicing physicians, there is increasing awareness within the patient safety movement that fatigue, even partial...

    journal_title:Obstetrics and gynecology

    pub_type: 杂志文章


    authors: Committee on Patient Safety and Quality Improvement.

    更新日期:2008-02-01 00:00:00

  • Microsurgical tubal reanastomosis--the role of splints.

    abstract::Tubal reanastomosis was performed in 32 patients using microsurgical techniques. In 25 women, occlusion was due to prior sterilization. A splint was not used during or after repair. Intrauterine pregnancy occurred in 21 (84%) and fetal loss in 6% of 17 potentially viable pregnancies. The mean midluteal serum progester...

    journal_title:Obstetrics and gynecology

    pub_type: 杂志文章


    authors: Meldrum DR

    更新日期:1981-05-01 00:00:00

  • Plasma Concentrations of Tranexamic Acid in Postpartum Women After Oral Administration.

    abstract:OBJECTIVE:To evaluate the pharmacokinetics of tranexamic acid after oral administration to postpartum women. METHODS:We conducted a single-center pharmacokinetic study at Teaching Hospital-Jaffna, Sri Lanka, on 12 healthy postpartum women who delivered vaginally. After oral administration of 2 g of immediate-release t...

    journal_title:Obstetrics and gynecology

    pub_type: 临床试验,杂志文章


    authors: Muhunthan K,Balakumar S,Navaratnaraja TS,Premakrishna S,Arulkumaran S

    更新日期:2020-04-01 00:00:00

  • Fetal sex determination by ultrasound.

    abstract::Real time ultrasonographic examination of the fetal perineal area after 30 weeks of gestation can reveal the external genitalia of the male fetus. The absence of this finding indicates a female fetus. This assessment is possible in up to two-thirds of cases, being limited only by the fetal presentation, position, and ...

    journal_title:Obstetrics and gynecology

    pub_type: 杂志文章


    authors: Stocker J,Evens L

    更新日期:1977-10-01 00:00:00

  • Uterine contraction pressures with oxytocin induction/augmentation.

    abstract::Uterine contraction pressures were quantified (in Montetevideo units) in 109 women at term gestation who received oxytocin for induction or augmentation of labor and whose labor resulted in a spontaneous vaginal delivery. Newborn five-minute Apgar scores were greater than or equal to 8 in 108 of the 109 neonates, and ...

    journal_title:Obstetrics and gynecology

    pub_type: 杂志文章


    authors: Hauth JC,Hankins GD,Gilstrap LC 3rd,Strickland DM,Vance P

    更新日期:1986-09-01 00:00:00

  • Loop electrosurgical excision procedure for squamous intraepithelial lesions of the cervix: advantages and potential pitfalls.

    abstract:OBJECTIVE:to evaluate the advantages and pitfalls of the loop electrosurgical excision procedure as applied to the diagnosis and treatment of cervical cancer precursors. METHODS:Loop electrosurgical excision procedure using local anesthesia and colposcopic guidance was performed in an outpatient clinical setting in 11...

    journal_title:Obstetrics and gynecology

    pub_type: 杂志文章


    authors: Ferenczy A,Choukroun D,Arseneau J

    更新日期:1996-03-01 00:00:00

  • Predictors of antibiotic prophylactic failure in post-cesarean endometritis.

    abstract::Despite the use of prophylactic antibiotics, endometritis occurs in 1-31% of patients after cesarean delivery. We sought to identify predictors of prophylactic antibiotic failure. In a retrospective review of 1800 cesarean deliveries, 766 patients had either ampicillin or cefazolin prophylaxis; 240 (31.3%) developed e...

    journal_title:Obstetrics and gynecology

    pub_type: 杂志文章


    authors: Chang PL,Newton ER

    更新日期:1992-07-01 00:00:00

  • Repeat measurement of cervical length after successful tocolysis.

    abstract:OBJECTIVE:To measure the ultrasonographic cervical length in undelivered women after successful tocolysis for preterm labor, and to determine whether this could improve the predictive value of cervical length measured before initiation of tocolysis on the risk of preterm delivery. METHODS:This was a prospective study ...

    journal_title:Obstetrics and gynecology

    pub_type: 杂志文章


    authors: Rozenberg P,Rudant J,Chevret S,Boulogne AI,Ville Y

    更新日期:2004-11-01 00:00:00

  • Primary ovarian pregnancy in a cystic teratoma.

    abstract::Hemoperitoneum was identified by culdocentesis in a 26-year-old woman suffering acute abdominal pain. A pregnancy test was positive. Operation indicated a ruptured ovarian pregnancy, and histologic examination revealed primary intrafollicular ovarian pregnancy in a cystic teratoma. Ovarian pregnancy in an ovarian tumo...

    journal_title:Obstetrics and gynecology

    pub_type: 杂志文章


    authors: Yu TJ,Iwasaki I,Teratani T,Tanaka T,Aoki M

    更新日期:1984-09-01 00:00:00

  • Neonatal outcomes with placenta previa.

    abstract:OBJECTIVE:To identify neonatal complications associated with placenta previa. METHODS:This was a population-based, retrospective cohort study involving all singleton deliveries in Nova Scotia from 1988 to 1995. The study group consisted of all completed singleton pregnancies complicated by placenta previa; all other s...

    journal_title:Obstetrics and gynecology

    pub_type: 杂志文章


    authors: Crane JM,van den Hof MC,Dodds L,Armson BA,Liston R

    更新日期:1999-04-01 00:00:00

  • Amniocentesis and the management of premature labor.

    abstract::Two applications of amniocentesis for the evaluation of the patient in idiopathic premature labor, fetal lung maturity testing, and detection of occult intraamniotic infection were evaluated in a review of 59 cases. Seven patients (12%) had positive amniotic fluid cultures despite the absence of clinical signs of infe...

    journal_title:Obstetrics and gynecology

    pub_type: 杂志文章


    authors: Leigh J,Garite TJ

    更新日期:1986-04-01 00:00:00

  • Bremelanotide for the Treatment of Hypoactive Sexual Desire Disorder: Two Randomized Phase 3 Trials.

    abstract:OBJECTIVE:To evaluate the safety and efficacy of bremelanotide for the treatment of premenopausal women with hypoactive sexual desire disorder. METHODS:Two identical phase 3, randomized, double-blind, placebo-controlled, multicenter clinical trials (RECONNECT) evaluated the safety and efficacy of bremelanotide 1.75 mg...

    journal_title:Obstetrics and gynecology

    pub_type: 杂志文章,多中心研究,随机对照试验


    authors: Kingsberg SA,Clayton AH,Portman D,Williams LA,Krop J,Jordan R,Lucas J,Simon JA

    更新日期:2019-11-01 00:00:00

  • Relation of various epidemiologic factors to cervical cancer as determined by a screening program.

    abstract::This study attempted to elucidate the etiology of cervical cancer by examining its association with a number of factors in a relatively unselected group of women. In 1963, a cytologic screening program was undertaken in Washington County, Maryland. The irrigation smear method was used. The final study group of 4341...

    journal_title:Obstetrics and gynecology

    pub_type: 杂志文章


    authors: Naguib SM,Lundin FE Jr,Davis HJ

    更新日期:1966-10-01 00:00:00

  • Vaginal hysterectomy for sterilization.

    abstract::Vaginal hysterectomy for sterilization was performed on 115 patients. The Heaney technique was used by nine gynecologists, using lidocaine and adrenaline. The average age of patients was 32.2 years and average parity 3.2. Significant unsuspected pathology was found after surgery in 21 patients. One postoperative d...

    journal_title:Obstetrics and gynecology

    pub_type: 杂志文章


    authors: Atkinson SM Jr,Chappell SM

    更新日期:1972-05-01 00:00:00

  • Urinary retention secondary to a Gartner's duct cyst.

    abstract::A 22-month-old child with a large cyst of Gartner's duct suffered from recurrent episodes of urinary retention. Excision of such large symptomatic cysts has been recommended in the past. Marsupialization is discussed as an alternative to extensive excision. ...

    journal_title:Obstetrics and gynecology

    pub_type: 杂志文章


    authors: Muram D,Jerkins GR

    更新日期:1988-09-01 00:00:00

  • Pregnancy following surgical correction of nonfused müllerian bulbs and absent vagina.

    abstract::The authors treated a 15-year-old girl with a nonfused mullerian system and absence of the cervix and vagina. Surgical reconstruction of the uterus and vagina were performed, after which menstruation first appeared. Postoperative fibrotic stenosis obliterated almost the entire vagina except for a fine uterovaginal fis...

    journal_title:Obstetrics and gynecology

    pub_type: 杂志文章


    authors: Singh J,Devi YL

    更新日期:1983-02-01 00:00:00

  • Hysteroscopic resection of intrauterine scars using a new technique.

    abstract::The authors describe a 5-year experience with 27 patients who had confirmed intrauterine scars at hysteroscopy, all of whom underwent resection of the scar. Of the 27, 14 became pregnant at least once, and 13 did not conceive. Hysteroscopic and hysterographic evidence of intrauterine scar was in general more severe in...

    journal_title:Obstetrics and gynecology

    pub_type: 杂志文章


    authors: Neuwirth RS,Hussein AR,Schiffman BM,Amin HK

    更新日期:1982-07-01 00:00:00

  • CA 125 serum levels correlated with second-look operations among ovarian cancer patients.

    abstract::CA 125, which is an antigenic determinant expressed by many epithelial ovarian cancers, is measured in serum using a solid phase immunoradiometric assay. Sera from 55 patients who were in clinical remission and underwent a second-look operation to assess disease status after chemotherapy were studied prospectively. Al...

    journal_title:Obstetrics and gynecology

    pub_type: 杂志文章


    authors: Berek JS,Knapp RC,Malkasian GD,Lavin PT,Whitney C,Niloff JM,Bast RC Jr

    更新日期:1986-05-01 00:00:00

  • Surgeon General's Conference on the Prevention of Preterm Birth.

    abstract::To address the serious and seemingly intractable problem of preterm birth, the Surgeon General's Conference on the Prevention of Preterm Birth convened many of the country's experts from the public and private sectors of research, public health, and health care delivery to discuss preventive strategies. The purpose of...

    journal_title:Obstetrics and gynecology

    pub_type: 共识发展会议,杂志文章


    authors: Ashton DM,Lawrence HC 3rd,Adams NL 3rd,Fleischman AR

    更新日期:2009-04-01 00:00:00

  • Vascular injury during tension-free vaginal tape procedure for stress urinary incontinence.

    abstract:BACKGROUND:Tension-free vaginal tape procedure is a popular surgical treatment of genuine stress urinary incontinence. CASES:Two cases of retropubic hematoma after tension-free vaginal tape procedure are reported. One woman with an 8 x 10 cm hematoma localized to the retropubic space required transfusion of two units ...

    journal_title:Obstetrics and gynecology

    pub_type: 杂志文章


    authors: Walters MD,Tulikangas PK,LaSala C,Muir TW

    更新日期:2001-11-01 00:00:00

  • Health Care Provider Adherence to Surgical Guidelines for Risk-Reducing Salpingo-Oophorectomy.

    abstract:OBJECTIVE:To evaluate health care provider adherence to the surgical protocol endorsed by the National Comprehensive Cancer Network and the American College of Obstetricians and Gynecologists at the time of risk-reducing salpingo-oophorectomy and compare adherence between gynecologic oncologists and obstetrician-gyneco...

    journal_title:Obstetrics and gynecology

    pub_type: 杂志文章,多中心研究


    authors: Wilhite AM,Oestreich MC,Olson M,Bedell SM,Westenberg D,Bangdiwala A,Ikramuddin S,Sanchez-Avila M,Madoff RD,Khalifa MA,Erickson BK

    更新日期:2019-09-01 00:00:00

  • Urethral closure pressure and leak-point pressure in incontinent women.

    abstract:OBJECTIVE:To examine the association between maximum urethral closure pressure and Valsalva leak-point pressure in women with genuine stress incontinence (GSI). METHODS:Fifty-six women with GSI were evaluated in a urodynamics laboratory. Maximum urethral closure pressure and vesical leak-point pressure were measured w...

    journal_title:Obstetrics and gynecology

    pub_type: 杂志文章


    authors: Sultana CJ

    更新日期:1995-11-01 00:00:00

  • Umbilical artery waveforms in triplet pregnancy.

    abstract::Twenty patients with triplet pregnancies underwent continuous-wave Doppler ultrasound umbilical artery waveform studies as part of a multiple-pregnancy surveillance program. One or more infants was small for gestational age in nine of these triplet pregnancies. In all of these cases, at least one abnormal umbilical ar...

    journal_title:Obstetrics and gynecology

    pub_type: 杂志文章


    authors: Giles WB,Trudinger BJ,Cook CM,Connelly AJ

    更新日期:1990-05-01 00:00:00

  • Evaluation of the endocervical Cytobrush and Cervex-Brush in pregnant women.

    abstract:OBJECTIVE:To compare, in pregnant women, the endocervical cell yield of the Cytobrush Cell Collector and the Cervex-Brush Cell Sampler with the standard cotton swab, and to determine the incidence of serious adverse events associated with the collection techniques. METHODS:In a randomized, controlled clinical trial, 3...

    journal_title:Obstetrics and gynecology

    pub_type: 临床试验,杂志文章,随机对照试验


    authors: Paraiso MF,Brady K,Helmchen R,Roat TW

    更新日期:1994-10-01 00:00:00