Doença trofoblástica gestacional: análise do diagnóstico, tratamento e seguimento no estado de Sergipe

Abstract

CONTEXT AND OBJECTIVE: Gestational trophoblastic disease (GTD) consist in the result of an aberrant fertilization generates a set of changes in the human trophoblast. This is an important problem for morbidity and mortality and the risk of impaired fertility. The objective is to evaluate the diagnosis, treatment and follow-up of patients with gestational trophoblastic disease. DESIGN AND SETTING: The study is observational and retrospective cross-sectional nature, and was held at Maternidade Nossa Senhora de Lourdes and Hospital de Urgência de Sergipe, in the city of Aracaju-SE, METHODS: We carried out a review of medical records of patients diagnosed with gestational trophoblastic disease in Maternidade Nossa Senhora de Lourdes and Hospital de Urgência de Sergipe, in the city of Aracaju-SE, from January 2009 to December 2012. Frequency of the studied variables was presented in percentage, mean, median and standard default and used the method of p value Correlation and Spearman's Rho. RESULTS: We identified 101 cases of DTG representing an incidence of 6,576 / 1,000 live births; 56.4% of women were aged between 21 and 35 years. The gestation period at the time of diagnosis was between 9-20 weeks in 69.3%. The most prevalent type was the DTG hydatidiform mole. In 25.58% of the hydatidiform mole progressed to invasive spring, prompting the initiation of chemotherapy, and the scheme with methotrexate and Leucovorin was used in 66.66%; and 33.33% (n = 4) received the AME-CO scheme. The time between the curettage and a negative β-hCG was higher for full spring that took an average of 171 days to negative; incomplete spring there was an average of 62 days, which is considered a significant correlation (p = 0.013). As a complication of DTG, 4.65% of patients studied with pulmonary metastasis. CONCLUSIONS: The diagnosis of DGT was defined by the clinical status of the patient, imaging and laboratory (β-hCG). The treatment of DTG was variable depending on the extent of the disease, but appropriate for each patient, allowing disease remission in 67.44%. Regarding the follow-up, patients with complete hydatidiform mole had a negative levels of β-hCG more Late that patients with incomplete hydatidiform mole. The dropout rate of follow-up was quite high, around 32.56%.