Association of the hook effect with life-threatening complications in women with hydatidiform mole

• Grant number: 21/00011-9
• Support Opportunities: Scholarships in Brazil - Scientific Initiation
• Start date: June 01, 2021
• End date: November 30, 2022
• Field of knowledge: Health Sciences - Medicine - Maternal and Child Health
• Principal Investigator: Izildinha Maestá
• Grantee: Mariana Pacchioni
• Host Institution: Faculdade de Medicina (FMB). Universidade Estadual Paulista (UNESP). Campus de Botucatu. Botucatu , SP, Brazil

Abstract

Potentially life-threatening complications and maternal near miss events such as hemorrhage, pre-eclampsia with severe features, thyrotoxic crisis and respiratory failure may be associated with the late diagnosis of hydatidiform mole (HM). The hook effect, which produces a false negative pregnancy test despite high titers of serum human chorionic gonadotropin (hCG), is a contributing factor to delay in the diagnosis of HM. Objectives: The purpose of this study is to evaluate the association of the hook effect with potentially life threatening conditions and maternal near miss events in women with a diagnosis of complete hydatidiform mole (CHM) initially treated at the Botucatu Trophoblastic Disease Center, São Paulo State University (BTDC / Unesp). Methods: Retrospective cohort study of 280 women with CHM referred to BTDC/Unesp for initial treatment between 1990 and 2020. Information on the presence of the hook effect and the occurrence of potentially life-threatening conditions and maternal near miss events between hospital admission for uterine evacuation and hospital discharge will be obtained. These conditions will be identified according to the criteria of the World Health Organization (2009). The following variables will be considered as potential confounders: maternal age at diagnosis, gestational age, uterine size and pre-evacuation hCG level. The statistical analysis of the occurrence of potentially life-threatening complications and maternal near miss events due to the presence of the hook effect will be analyzed using adjusted Poisson models. (AU)