Hormonal contraceptive use before hCG remission does not increase the risk of gestational trophoblastic neoplasia following complete hydatidiform mole: a historical database review

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dc.contributor.authorBraga, A.
dc.contributor.authorMaestá, I. [UNESP]
dc.contributor.authorShort, D.
dc.contributor.authorSavage, P.
dc.contributor.authorHarvey, R.
dc.contributor.authorSeckl, M. J.
dc.contributor.institutionUnivesidade Federal do Rio de Janeiro (UFRJ)
dc.contributor.institutionUniversidade Federal Fluminense (UFF)
dc.contributor.institutionImperial College School of Medicine
dc.contributor.institutionUniversidade Estadual Paulista (Unesp)
dc.date.accessioned2015-12-07T15:39:03Z
dc.date.available2015-12-07T15:39:03Z
dc.date.issued2015-10-07
dc.description.abstractTo re-evaluate the safety of hormonal contraceptives (HC) after uterine evacuation of complete hydatidiform mole (CHM). Historical database review. Charing Cross Hospital Gestational Trophoblastic Disease Centre, London, United Kingdom. Two thousand four hundred and twenty-three women with CHM of whom 154 commenced HC while their human chorionic gonadotropin (hCG) was still elevated, followed between 2003 and 2012. We compared time to hCG remission between HC users and nonusers. The relationship between HC use and gestational trophoblastic neoplasia (GTN) development was assessed. The relationship between HC use and a high International Federation of Gynecology and Obstetrics (FIGO) risk score was determined. Time to hCG remission, risk of developing postmolar GTN and proportion of women with high FIGO risk score. No relationship was observed between HC use with mean time to hCG remission (HC users versus non-users: 12 weeks in both, P = 0.19), GTN development (HC users versus non-users: 20.1 and 16.7%, P = 0.26) or high-risk FIGO score (HC users versus nonusers: 0% and 8%, P = 0.15). Moreover, no association between HC and GTN development was found, even when an age-adjusted model was used (OR = 1.37, 95% CI 0.91-2.08, P = 0.13). The use of current HC is not associated with development of postmolar GTN or delayed time to hCG remission. Therefore, HC can be safely used to prevent a new conception following CHM regardless of hCG level. Non-concurrent cohort study to re-evaluate the safety of low dose HCs after uterine evacuation of CHM.en
dc.description.affiliationTrophoblastic Disease Center, Maternity School of Rio de Janeiro Federal University and Antonio Pedro University Hospital at Fluminense Federal University, Rio de Janeiro, RJ, Brasil
dc.description.affiliationPostdoctoral Program of Science without Borders (Brazilian Government) - Charing Cross Gestational Trophoblastic Disease Centre, Charing Cross Hospital, Imperial College School of Medicine, London, UK
dc.description.affiliationPós-Graduação em Ginecologia, Obstetrícia e Mastologia, Faculdade de Medicina de Botucatu (FMB), Universidade Estadual Paulista (UNESP), Botucatu, SP, Brasil
dc.description.affiliationTrophoblastic Disease Center, Departamento de Ginecologia e Obstetrícia, Faculdade de Medicina de Botucatu, Universidade Estadual Paulista (UNESP), Botucatu, SP, Brasil
dc.description.affiliationCharing Cross Gestational Trophoblastic Disease Centre, Charing Cross Hospital, Imperial College School of Medicine, London, UK
dc.description.affiliationUnespPós-Graduação em Ginecologia, Obstetrícia e Mastologia, Faculdade de Medicina de Botucatu (FMB), Universidade Estadual Paulista (UNESP), Botucatu, SP, Brasil
dc.description.affiliationUnespTrophoblastic Disease Center, Departamento de Ginecologia e Obstetrícia, Faculdade de Medicina de Botucatu, Universidade Estadual Paulista (UNESP), Botucatu, SP, Brasil
dc.description.sponsorshipHealth ResearchBiomedical Research Centre (NIHR BRC)
dc.format.extent1-6
dc.identifierhttp://dx.doi.org/10.1111/1471-0528.13617
dc.identifier.citationBjog: an International Journal of Obstetrics and Gynaecology, 2015.
dc.identifier.doi10.1111/1471-0528.13617
dc.identifier.issn1471-0528
dc.identifier.lattes9012667997804219
dc.identifier.pubmed26444183
dc.identifier.urihttp://hdl.handle.net/11449/131629
dc.language.isoeng
dc.publisherRoyal College of Obstetricians and Gynaecologists
dc.relation.ispartofBjog: an International Journal of Obstetrics and Gynaecology
dc.relation.ispartofsjr2,111
dc.rights.accessRightsAcesso restrito
dc.sourcePubMed
dc.subjectGestational trophoblastic neoplasiaen
dc.subjectHormonal contraceptivesen
dc.subjectHuman chorionic gonadotropinen
dc.subjectHydatidiform moleen
dc.subjectOestrogenen
dc.subjectProgestogenen
dc.titleHormonal contraceptive use before hCG remission does not increase the risk of gestational trophoblastic neoplasia following complete hydatidiform mole: a historical database reviewen
dc.typeArtigo
dcterms.rightsHolderRoyal College of Obstetricians and Gynaecologists
unesp.author.lattes9012667997804219
unesp.campusUniversidade Estadual Paulista (Unesp), Faculdade de Medicina, Botucatupt

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