Prevention of Post-Mole Malignant Trophoblastic Disease withVitamin A


Objective: Around 15-28% of hydatidiform mole patients suffer from malignant degeneration followingevacuation. Since retinoic acid can control cell proliferation and stimulate apoptosis, vitamin A could be usedas a therapy for preventing such malignant transformation. The objective of this study was to demonstratethe use of vitamin A as a chemoprevention following hydatidiform mole development. Materials and methods:The study made use of a randomized clinical trial, double blind protocol. Subjects were patients with completehydatidiform moles, not receiving cytostatics. The intervention was administration of placebo or vitamin Aat 200,000 IU per day, performed until the patients were declared as having recovered or having malignanttrophoblastic disease (MTD). The outcome variables were the incidence of regression and MTD, establishedbased on WHO criteria.
Results: At clinical trial as many as 67 cases met the requirements for the study. Twocases were lost from observation and three experienced pregnancy. The incidence rate of malignant trophoblasticdisease in the control group was 28.6%, and in the therapy group was 6.3%. No difference was found in thechanges of SGOT and SGPT levels of the therapy group compared with the control group.
Conclusion: Therate of malignant trophoblastic disease (MTD) was reduced in the group receiving vitamin A therapy.