Psychological and Emotional Impact on Patients and Families

Hogg, Marianne; Knapp, Judith E.; Lappa, Constance L.

doi:10.1007/978-1-4612-4698-5_17

Cited by 2 publications

(6 citation statements)

References 10 publications

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“…All types of GTD affect women in menacme, most of whom begin their reproductive life (1,4,17,20) as shown in our results. When this gestational pathology is diagnosed, patients need early and accurate clinical and psychological care to reduce physical and emotional morbidity, so that, once GTD is overcome, they can return to good health and have a normal reproductive future (7,13,14,38,39). It is now a consensus that the follow up of GTD patients should be carried out at reference centers (9,15,20,23,30), and our TDC results reinforce this orientation.…”

Section: Discussionsupporting

confidence: 57%

“…When all these difficulties are associated with a molar gestation and all its implications, the emotional problems of pregnant adolescents are intensified (13,38). The term GTD encompasses a group of diseases that requires prolonged follow up, and in 20% of cases leads to antineoplastic chemotherapy and the social stigma that neoplasms carry (7,14,20,38,39). The support of the family and partner, as well as participation in support group meetings, is fundamental for adolescent patients with GTD.…”

Section: Discussionmentioning

confidence: 99%

“…Adhesion to follow up is higher when adolescents understand GTD and its risks, are continually motivated, and are mature enough to follow the proposed protocol, which includes strict and effective contraception until the levels of chorionic gonadotropin have been negative for approximately 1 year (7,8,11,12). The development of persistent GTD (PGTD) after a molar gestation, and especially of GTT after other types of gestation (abortion, ectopic and term pregnancies), intensifies the physical and emotional morbidity (10,(13)(14)(15).…”

mentioning

confidence: 99%

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Gestational trophoblastic disease: one more risk in adolescent pregnancy

Uberti¹,

Diestel²,

Guimarães³

et al. 2002

Acta Obstet Gynecol Scand

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Background. An evaluation of the performance of a Referral Center in the diagnosis, treatment and follow up of adolescents with gestational trophoblastic disease. Methods. In a 13-year prospective cohort study, between March 1987 and March 2000, 124 adolescents with gestational trophoblastic disease were followed up and/or treated by a multidisciplinary team. Adolescents underwent strict clinical and laboratory control after mole evacuation to guarantee adhesion to follow up, early diagnosis, and prompt treatment of persistent disease. The Student-Fischer t-test and the chi-square test were used for the statistic analysis of the results. Results. Adolescents represented 21.3% of the 583 patients with gestational trophoblastic disease: 102 (82.3%) had uncomplicated hydatidiform moles, and 22 (17.7%) underwent chemotherapy for persistent gestational trophoblastic disease or a gestational trophoblastic tumor. Complications were diagnosed earlier (p Ͻ 0.001) in patients managed and treated at the referral center. Of the adolescents with complications, 81.8% were low risk, 54.5% were at the International Federation of Gynecology and Obstetrics stage I, and 90.9% were treated with chemotherapy only. Time to remission and follow up were shorter for uncomplicated hydatidiform moles (9.8 ∫ 3.4 weeks and 8.8 ∫ 1.8 months, respectively) than for persistent disease (16.2 ∫ 5.8 weeks and 45 ∫ 24.5 months, respectively). Adhesion to follow up was similar in the two groups (84.2% and 91.8%). To this date, 50% of the adolescents have had one or more gestations, and 82% of these pregnancies were normal. Conclusions. Adolescents comprise approximately 20% of all gestational trophoblastic disease patients and have high adhesion to follow up. The disease did not affect their reproductive capacity, and chances of a normal subsequent gestation were high.

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