Associação da Dopplervelocimetria das artérias uterinas com a evolução clínica da Mola hidatiforme

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Data

2015-08-25

Orientador

Maestá, Izildinha
Consonni, Marcos

Coorientador

Pós-graduação

Ginecologia, Obstetrícia e Mastologia - FMB

Curso de graduação

Título da Revista

ISSN da Revista

Título de Volume

Editor

Universidade Estadual Paulista (Unesp)

Tipo

Dissertação de mestrado

Direito de acesso

Acesso abertoAcesso Aberto

Resumo

Doppler ultrasonography can be used to assess neoangiogenesis, a characteristic feature of postmolar gestational trophoblastic neoplasia (GTN). However, there is limited information on whether uterine artery Doppler flow velocimetry (DFV) can predict GTN following complete hydatidiform mole (CHM). The purpose of this study was: 1) to compare uterine blood flow before and after CHM evacuation between women who developed post-molar GTN and those who achieved spontaneous remission; 2) to assess the usefulness of uterine DFV parameters as predictors of post-CHM GTN, and to determine the best parameters and cutoff values for predicting post-CHM GTN. Methods. This prospective cohort study included246 CHM patients attending three trophoblastic diseases centers (Botucatu -Sao Paulo State University, Rio de Janeiro Federal University and Fluminense Federal University) between 2013 and 2014. Pulsatility index (PI), resistivity index (RI), and sistolic/dyastolic ratio (S/D) were measured by DVF before and 4-6 weeks post CHM evacuation. Statistical analysis was performed using Wilcoxon's test, logistic regression and ROC analysis. Results. No differences in pre- and postevacuation DVF measurements were observed in patients who developed post-CHM GTN. In those that achieved spontaneous remission, PI and SD were increased after evacuation. Pre- and post-evacuation PI was significantly lower in patients who developed GTN with estimates of odds ratio of 13.9-30.5. Pre-evacuation PI ≤1.38 (77% sensitivity, 82% specificity), and post-evacuation PI≤1.77 (79% sensitivity, 86% specificity) were significantly predictive of GTN. Conclusions. Uterine DFV measurements, particularly pre- and post-molar evacuation PI, can be useful for predicting post-CHM GTN

Descrição

Idioma

Português

Como citar

ASMAR, Flavia Tarabini Castellani. Associação da Dopplervelocimetria das artérias uterinas com a evolução clínica da Mola hidatiforme. 2015. 1 CD-ROM. Dissertação (mestrado) - Universidade Estadual Paulista Júlio de Mesquita Filho, Faculdade de Medicina de Botucatu, 2015.

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