Clinical presentation of molar pregnancy and risks for gestational trophoblastic neoplasia in advanced maternal age

• Grant number: 15/01899-2
• Support Opportunities: Scholarships in Brazil - Scientific Initiation
• Start date: June 01, 2015
• End date: May 31, 2016
• Field of knowledge: Health Sciences - Medicine - Maternal and Child Health
• Principal Investigator: Izildinha Maestá
• Grantee: Isabela Bueno Stolar
• Host Institution: Faculdade de Medicina (FMB). Universidade Estadual Paulista (UNESP). Campus de Botucatu. Botucatu , SP, Brazil

Abstract

Introduction. Studies have shown variation of the clinical presentation of the hydatidiform mole (HM) and of the risk of developing gestational trophoblastic neoplasia (GTN) in women e 40 years. The incidence of complete hydatidiform mole (CHM), as well as the need of chemotherapy after CHM, are dramatically affected by the increasing of age. However, there is a general trend towards delaying pregnancy, due to the women's desire of improving their educational and socioeconomic status. Objectives. The purpose of this study is to compare the differences of clinical presentations of CHM and the clinical risk factors for developing GTN between women e 40 years and < 40 years. Methods. Nonconcurrent cohort study that will include CHM patients evaluated in five South American centers in Brazil, Argentina and Venezuela, between 1990 and 2011. The clinical features including age, gestational age at the diagnosis, uterine size, pre-evacuation serum hCG levels, presence of theca lutein cysts, anemia, vaginal bleeding, gestational hypertension/preeclampsia, hyperemesis gravidarum and breathing discomfort syndrome were determined according to database and medical records of all patients. The women will be divided in two groups: e 40 years (group A) and < 40 years (group B). The diagnosis of post-CHM GTN will be established according to the FIGO 2002 criteria. The GTN risk factors will be identified by Odds Ratio (OR), Chi-square test or Fisher exact test. The comparison of the effect of each factor for the development of post-CHM GTN between the groups e 40 years (group A) and < 40 years (group B) will be done considering a confidence interval (CI) of the Odds Ratio, with a significant level set at p < 0,05.