Adesão ao seguimento ambulatorial de pacientes com doença trofoblástica gestacional atendidas em um centro de referência

Mendonça, Julianna Barroso Rizzo; Soares, Leonardo Ribeiro; Viggiano, Maurício

doi:10.1016/j.recli.2016.04.007

Cited by 2 publications

(2 citation statements)

References 13 publications

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“…In the Gestational Trophoblastic Disease Center, São Paulo Hospital, patients who were lost to post-molar follow-up with positive hCG represent 7.1% (n=22) and those with incomplete follow-up represent 34.4% (n=106) of the sample analyzed, with only 58% (n=180) of patients with complete post-molar follow-up. A similar proportion was seen in Goiania’s Reference Center (49.1% of complete follow-up),27 indicating that high drop out and incomplete post-molar follow-up rates are a reality. Patients lost to post-molar follow-up provoke uncertainties that can result in constant worry related to women’s health, compromising their personal and professional lives, and therefore reducing their well-being.…”

Section: Discussionsupporting

confidence: 60%

Telemedicine in post-molar follow-up: is it a useful tool?

Assis

Morais

Freitas

et al. 2022

Int J Gynecol Cancer

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BackgroundTelemonitoring is an alternative to in-person appointments and overcomes geographic distance barriers.ObjectiveThe primary objective of this study was to evaluate adherence to post-molar follow-up using both WhatsApp and in-person appointments compared with standard care. The secondary objective was to evaluate the rate of completion of post-molar follow-up of complete moles, considering 6 and 3 months of duration.MethodsThis retrospective cohort study was conducted at the Gestational Trophoblastic Disease Center, São Paulo Hospital. Patients with complete or partial mole treatment between January 1, 2009 and December 31, 2018 were included in two groups: group 1 (patients from 2009 to 2013) and group 2 (from 2014 to 2018), before and after telemonitoring implementation, respectively. Complete follow-up was considered if after the first normal human chorionic gonadotropin (hCG) level (<5 mIU/mL), the patient was followed up for an additional 30 days (partial mole) or 180 days (complete mole). Loss to post-molar follow-up with positive hCG was also evaluated. Statistical analysis was performed using Pearson’s Χ2 test, 5% significance level (p=0.05), and R version 4.0.2.ResultsA total of 308 patients were included in the study, 92 of them were assessed in group 1 and 216 patients in group 2. There was no difference between the rates of complete follow-up after telemonitoring implementation (complete mole: 42/72=58.3% group 1 vs 85/163=52.1% group 2; p=0.38; partial mole: 16/20=80% group 1 vs 37/53=69.8 group 2; p=0.3), and no increase of loss to post-molar follow-up with positive hCG (8/92=8.7% group 1 vs 14/216=6.5% group 2; p=0.49). The shortening of follow-up of complete moles to 90 days increased the rate of complete post-molar follow-up (from 127/235=54.0% to 189/235=80.4%, p<0.001).ConclusionsThe association of telemonitoring with in-person appointments could have had an advantage in post-molar follow-up since it did not reduce adherence to hormonal surveillance. Shortening post-molar follow-up after complete mole to 90 days after the first normal hCG level increased the rate of complete post-molar follow-up.

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Section: Discussionsupporting

confidence: 60%

Telemedicine in post-molar follow-up: is it a useful tool?

Assis

Morais

Freitas

et al. 2022

Int J Gynecol Cancer

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“…No que concerne à diferenciação dos tipos de mola hidatiforme, nos casos em que foi realizado a diferenciação, a maioria das mulheres do presente estudo apresentou diagnóstico de mola completa, o que corrobora com o estudo realizado em Goiás onde o tipo clínico mais comum de DTG foi mola completa, assim como em um estudo na Colômbia. Entretanto, em muitos estudos na literatura, assim como neste, foi possível identificar a presença de diagnósticos de mola hidatiforme sem a classificação de seu tipo (MENDONÇA JBR, et al, 2016;RAMÍREZ CAG, et al, 2018). A ausência dessa classificação pode dificultar o percurso durante o período de seguimento pós-molar, pois um diagnóstico diferencial poderia auxiliar os profissionais de saúde que dão seguimento à assistência para essas mulheres sobre a possibilidade de uma evolução para uma NTG.…”

Section: Discussionunclassified

Panorama da doença trofoblástica gestacional numa capital do nordeste

et al. 2020

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Objetivo: Analisar o panorama da doença trofoblástica gestacional em uma capital do Nordeste brasileiro no período de 2013 e 2018. Métodos: trata-se de um estudo quantitativo, descritivo por pesquisa documental, realizado através da análise de prontuários. Resultados: foram encontrados 238 prontuários de mulheres com diagnóstico de gestação molar, com uma média de 40 casos diagnosticados por ano. A maioria das mulheres do presente estudo estava na faixa etária entre 20 e 24 anos (28%), era solteira (71,1%), de cor/raça parda (89,8%), com escolaridade de ensino médio completo/incompleto (42,3%), e apresentava tipagem sanguínea O (54%) e fator Rh positivo (92%). Quanto à história obstétrica, a maioria era primigesta (42,3%), apresentou quadro de mola completa (44%) e o tratamento de escolha mais utilizado foi a aspiração manual intrauterina (44,4%). Conclusão: evidenciou-se que a doença trofoblástica gestacional é uma patologia que ocorreu numa pequena crescente no período de 2013 a 2018, mas com evolução clínica positiva.

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Adesão ao seguimento ambulatorial de pacientes com doença trofoblástica gestacional atendidas em um centro de referência

Cited by 2 publications

References 13 publications

Telemedicine in post-molar follow-up: is it a useful tool?

Telemedicine in post-molar follow-up: is it a useful tool?

Panorama da doença trofoblástica gestacional numa capital do nordeste

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