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[PMID]: | 28927899 |
[Au] Autor: | Dantas PRS; Maestá I; Filho JR; Junior JA; Elias KM; Howoritz N; Braga A; Berkowitz RS |
[Ad] Endereço: | Department of Gynecology and Obstetrics, Botucatu Medical School, Postgraduate Program of Gynecology, Obstetrics and Mastology of São Paulo State University. Rubião Júnior District, Botucatu, São Paulo, Brazil; Rio de Janeiro Trophoblastic Disease Center, Brazilian Association of Gestational Trophob |
[Ti] Título: | Does hormonal contraception during molar pregnancy follow-up influence the risk and clinical aggressiveness of gestational trophoblastic neoplasia after controlling for risk factors? |
[So] Source: | Gynecol Oncol;147(2):364-370, 2017 Nov. | [Is] ISSN: | 1095-6859 |
[Cp] País de publicação: | United States |
[La] Idioma: | eng |
[Ab] Resumo: | OBJECTIVE: To evaluate the influence of hormonal contraception (HC) on the development and clinical aggressiveness of gestational trophoblastic neoplasia (GTN) and the time for normalization of human chorionic gonadotropin (hCG) levels. METHODS: A retrospective cohort study was conducted with women diagnosed with molar pregnancy, followed at the Rio de Janeiro Trophoblastic Disease Center, between January 2005 and January 2015. The occurrence of postmolar GTN and the time for hCG normalization between users of HC or barrier methods (BM) during the postmolar follow-up or GTN treatment were evaluated. RESULTS: Among 2828 patients included in this study, 2680 (95%) used HC and 148 (5%) used BM. The use of HC did not significantly influence the occurrence of GTN (ORa: 0.66, 95% CI: 0.24-1.12, p=0.060), despite different formulations: progesterone-only (ORa: 0.54, 95% CI: 0.29-1.01, p=0.060) or combined oral contraception (COC) (ORa: 0.50, 95% CI: 0.27-1.01, p=0.60) or with different dosages of ethinyl estradiol: 15mcg (ORa, 1.33, 95% CI 0.79-2.24, p=0.288), 20mcg (ORa: 1.02, 95% CI: 0.64-1.65, p=0.901), 30mcg (ORa: 1.17, 95% CI: 0.78-1.75, p=0.437) or 35mcg (ORa: 0.77, 95% CI: 0.42-1.39, p=0.386). Time to hCG normalization ≥10weeks (ORa: 0.58, 95% CI: 0.43-1.08, p=0.071) or time to remission with chemotherapy≥14weeks (ORa: 0.60, 95% CI: 0.43-1.09, p=0.067) did not significantly differ among HC users when compared to patients using BM, when controlling for other risk factors using multivariate logistic regression. CONCLUSIONS: The use of HC during postmolar follow-up or GTN treatment does not seem to increase the risk of GTN or its severity and does not postpone the normalization of hCG levels. |
[Mh] Termos MeSH primário: |
Anticoncepcionais Orais Hormonais/administração & dosagem Doença Trofoblástica Gestacional/epidemiologia Mola Hidatiforme/terapia
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[Mh] Termos MeSH secundário: |
Adulto Gonadotropina Coriônica/sangue Estudos de Coortes Dispositivos Anticoncepcionais Femininos Anticoncepcionais Orais Hormonais/efeitos adversos Feminino Seguimentos Doença Trofoblástica Gestacional/sangue Doença Trofoblástica Gestacional/etiologia Doença Trofoblástica Gestacional/patologia Seres Humanos Mola Hidatiforme/sangue Mola Hidatiforme/cirurgia Gravidez Estudos Retrospectivos Fatores de Risco
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[Pt] Tipo de publicação: | JOURNAL ARTICLE |
[Nm] Nome de substância:
| 0 (Chorionic Gonadotropin); 0 (Contraceptives, Oral, Hormonal) |
[Em] Mês de entrada: | 1711 |
[Cu] Atualização por classe: | 171108 |
[Lr] Data última revisão:
| 171108 |
[Sb] Subgrupo de revista: | IM |
[Da] Data de entrada para processamento: | 170921 |
[St] Status: | MEDLINE |
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