Pregnancy Outcomes After Single Agent Versus Multiagent Chemotherapy for Gestational Trophoblastic Neoplasia at Kenyatta National Hospital

Abstract

Background:gestational Trophoblastic Neoplasia (Gtn) Is a Rare and Treatable Cancer for Women Reported in About 2.4/1000 and 4.6/1000 Live Births in Two Separate Studies in Africa. It Occurs Because of Abnormal Proliferation of Trophoblastic Tissues. To Prevent Spontaneous Abortion and Lower the Risk of Adverse Maternal Outcomes Such as Stillbirth, the World Health Organisation (Who) Recommends Oral Contraceptionpostchemotherapy for Gtn and Delaying Pregnancy by 12 Months,if Low Risk, and 18 Months if High-risk. However, It Is Not Clear to What Extent These Proposals Are Followed in Kenya. The Pregnancy Outcomes of Women After Single Agent Chemotherapy Versus Multi Agent Therapy Have Likewisenever Been Explored. Objective: to Evaluate the Pregnancyoutcomes of Women Who Hadsingle Agent Chemotherapy Versus Multi Agent Chemotherapy for Gtns at Knh Between 2013 and 2017. Methodology: a Classicalcohort Studywas Done at the Health Information Department at the Kenyatta National Hospital (Knh).files Were Checked for Completeness and Patients Who Qualified for the Study Contacted on Phone. Oral Consent Was Administered Using a Telephone Transcript, 55 Patients Who Were Treated With Single Agent Chemotherapy and 55 Who Were Treated With Multi Agentchemotherapy for Gtnsrecruited, and Data on the Sociodemographic and Medical Characteristics of Cases Captured on a Questionnaire. Reproductive Outcomes Such as the Desire for Pregnancy, Eventual Pregnancy, and Birth Outcomes Wasalso Be Recorded During Phone Interviews and Filled on a Questionnaire. The Chi Square Test for Categorical Data and the T Test for Continuousdata Was Used to Analyse Study’s Data. The Comparability of Study Groups Wasestablished at Baseline and Confounders Controlled Using a Logistic Regression Model. Tests for Statistical Significance Was Interpreted at the 95% Confidence (P<0.05 Was Significant).version 21 of the Statistical Package for Social Scientists (Spss) Was Used for Data Analysis. Results:the Data of 55 Patients Who Received Monotherapy and 55 Multi Therapy Was Analysed. Patients Who Mono Therapy Were Younger Than Those Who Received Multi Therapy (P=0.01) and Had a Significantly Higher Level of Education (P=0.04). A Majority of Patients Who Received Multi Therapy Had a Higher Risk Status (P<0.01) and Were Likelier to Have Metastasised Cancer Than Those on Monotherapy (P=0.02). The Incidence of Pregnancy Was Significantly Higher Among Patients Who Received Mono Therapy (47.3%) Than Multi Therapy (20.5%), P<0.01. The Desire for Pregnancy Was Also Significantly Higher Among Patients Who Received Monotherapy (60.0%) Than Multi Therapy (38.3%). Contraceptive Use (63.6% Versus 58.2%) and the Live Birth Rate of Women Who Achieved a Pregnancy (73.1% Versus 72.7%) Were Comparable (P>0.05). Conclusion: Pregnancy Outcomes After Single or Multi-agent Chemotherapy Are Reassuring.