Clinical Presentation, Treatment Outcomes, and Resistance-related Factors in South American Women with Low-risk Postmolar Gestational Trophoblastic Neoplasia.

Objective:  There are few multinational studies on gestational trophoblastic neoplasia (GTN) treatment outcomes in South America. The purpose of this study was to assess the clinical presentation, treatment outcomes, and factors associated with chemoresistance in low-risk postmolar GTN treated with first-line single-agent chemotherapy in three South American centers.

Methods:  Multicentric, historical cohort study including women with International Federation of Gynecology and Obstetrics (FIGO)-staged low-risk postmolar GTN attending centers in Argentina, Brazil, and Colombia between 1990 and 2014.

Lack of experience is a main cause of maternal death in placenta accreta spectrum patients.

Introduction: Placenta accreta spectrum (PAS) is a serious condition with a mortality as high as 7%. However, the factors associated with this type of death have not been adequately described, with an almost complete lack of publications analyzing the determining factors of death in this disease. The aim of our work is to describe the causes of death related to PAS and to analyze the associated diagnosis and treatment problems.

Management practices for placenta accreta spectrum patients: a Latin American hospital survey.

Introduction: Placenta accreta spectrum (PAS) causes severe morbidity and can result in maternal death. It must be managed in specialized centers with interdisciplinary groups, but few publications have described the usual management within a specific geographic region. We intend to describe the usual approach for PAS in reference centers in Latin America.

Manual Compared With Electric Vacuum Aspiration for Treatment of Molar Pregnancy.

Objective: To evaluate uterine evacuation of patients with molar pregnancy, comparing manual with electric vacuum aspiration.

Methods: This is a retrospective cohort study of patients with molar pregnancy followed at the Rio de Janeiro Trophoblastic Disease Center from January 2007 to December 2016. The individual primary study outcomes were incomplete uterine evacuation, uterine perforation, development of uterine synechia, and development of postmolar gestational trophoblastic neoplasia.

Comparison of 2 Human Chorionic Gonadotropin Immunoassays Commercially Available for Monitoring Patients With Gestational Trophoblastic Disease.

Objective: The aim of this study was to compare serum human chorionic gonadotropin (hCG) levels in patients with gestational trophoblastic disease (GTD) using 2 commercially available hCG immunoassays.

Methods: Serum samples were obtained from patients with GTD attending the Botucatu Medical School Trophoblastic Diseases Center of São Paulo State University (UNESP), from November 2014 to October 2015. Serum hCG levels were measured with both Architect i2000SR and Immulite 2000 XPi chemiluminescence assays.

Uterine artery Doppler flow velocimetry parameters for predicting gestational trophoblastic neoplasia after complete hydatidiform mole, a prospective cohort study.

Objectives:: Doppler ultrasonography can be used to assess neoangiogenesis, a characteristic feature of postmolar gestational trophoblastic neoplasia. However, there is limited information on whether uterine artery Doppler flow velocimetry parameters can predict gestational trophoblastic neoplasia following a complete hydatidiform mole. The purpose of this study was as follows: 1) to compare uterine blood flow before and after complete mole evacuation between women who developed postmolar gestational trophoblastic neoplasia and those who achieved spontaneous remission, 2) to assess the usefulness of uterine Doppler parameters as predictors of postmolar gestational trophoblastic neoplasia and to determine the best parameters and cutoff values for predicting postmolar gestational trophoblastic neoplasia.

Complete molar pregnancy in adolescents from North and South America: Clinical presentation and risk of gestational trophoblastic neoplasia.

Objectives: To compare complete hydatidiform mole (CHM) clinical presentation and risk factors associated with GTN development between North American and South American adolescents.

Methods: This non-concurrent cohort study was undertaken including adolescents with CHM referred to centers in North America (New England Trophoblastic Disease Center, Harvard University, USA), and South America (Botucatu Trophoblastic Disease Center-São Paulo State University, Brazil; Trophoblastic Unit of Central University of Venezuela and Maternidad Concepcion Palacios of Caracas, Venezuela) between 1990 and 2012. Data were obtained from medical records and pathology reports.

Trophoblastic disease review for diagnosis and management: a joint report from the International Society for the Study of Trophoblastic Disease, European Organisation for the Treatment of Trophoblastic Disease, and the Gynecologic Cancer InterGroup.

Objective: The objective of this study was to provide a consensus review on gestational trophoblastic disease diagnosis and management from the combined International Society for the Study of Trophoblastic Disease, European Organisation for the Treatment of Trophoblastic Disease, and the Gynecologic Cancer InterGroup.

Methods: A joint committee representing various groups reviewed the literature obtained from PubMed searches.

Results And Conclusions: Guidelines were constructed on the basis of literature review.

Determining the time required to achieve negative human chorionic gonadotropin value after a nonmolar pregnancy: preliminary results.

Objective: To determine the time of human chorionic gonadotropin (hCG) regression in nonmolar gestation.

Study Design: Patients treated at our institution between June 2012 and July 2013 were selected by a deterministic sequential sampling distributed among 2 phases. Distribution of the patients included resolved cases by vaginal delivery and cesarean section in preterm and term pregnancies, ectopic, and abortion.

Hydatidiform mole in ectopic pregnancy: clinical, imaging, pathological and immunohistochemical characteristics.

Objective: To determine the clinical, pathological, immunohistochemical and imaging characteristics of hydatidiform mole in ectopic pregnancy (HMEP) in all the cases admitted to the Department of Obstetrics and Gynecology, University Hospital of Caracas (HUC), Central University of Venezuela.

Study Design: Retrospective and comparative study, based on clinical records review of 2 groups: 10 cases with a diagnosis of HMEP and 20 cases with intrauterine hydatidiform mole (IUHM) admitted to the Obstetrics and Gynecology Department of HUC from 1996 to 2010. Clinical, pathological, immunohistochemical and imaging features were analyzed.

Influence of hydatidiform mole follow-up setting on postmolar gestational trophoblastic neoplasia outcomes: a cohort study.

Objective: To assess the influence of hydatidiform mole (HM) management setting (reference center versus other institutions) on gestational trophoblastic neoplasia (GTN) outcomes.

Methods: This cohort study included 270 HM patients attending Botucatu Trophoblastic Diseases Center (BTDC, São Paulo State University, Brazil) between January 1990 and December 2009 (204 undergoing evacuation and entire postmolar follow-up at BTDC and 66 from other institutions [OIs]). GTN characteristics and outcomes were analyzed and compared according to HM management setting.

Geographical distribution and demographic characteristics of gestational trophoblastic disease.

Objective: To outline the geographical distribution pattern of gestational trophoblastic disease (GTD) in a referral center in Bahia, Brazil, and determine the demographics of the disease.

Study Design: We conducted a study of data retrieved from medical records of 140 GTD patients referred to our Trophoblastic Diseases Center in 2002-2007, assessing geographical distribution across health care districts, demographics, referral sources, and previous pregnancy status.

Results: The most common GTD types were hydatidiform mole (106, 75.

Utility of p57 protein(KIP2) in molar disease to determine its androgenetic origin.

Objective: To determine, qualitatively and semiquantitatively, the expression of p57 protein in different trophoblastic cell populations of hydatidiform mole and anembryonic pregnancy.

Study Design: We performed an observational study of the histopathologic and immunohistochemical findings of 48 cases of hydatidiform mole and 2 anembryonic pregnancies. The histologic samples stained with hematoxylin-eosin were reviewed blindly by 3 pathologists to establish a diagnosis and compare it to the previous one.

Histopathologic and immunohistochemical evaluation of blood vessels in complete and partial hydatidiform mole.

Objective: To assess 46 cases diagnosed as complete and partial hydatidiform mole in regard to their histopathologic aspects according to current World Health Organization (WHO) criteria and to determine whether their immunohistochemical features are related to the presence of blood vessels.

Study Design: An observational, descriptive study was done on the histopathologic and immunohistochemical findings of 46 molar pregnancy cases seen at the Gynecological Pathology Department, Anatomopathological Institute, Central University of Venezuela, during 1990-2003. Data were obtained primarily from the tumor registry.

Metastasis detection with 18 FDG-positron emission tomography/computed tomography in gestational trophoblastic neoplasia: a report of 2 cases.

Background: The imaging methods proposed by the International Consensus for the Diagnosis of Metastases in Trophoblastic Neoplasia are sufficient to stage the disease in most cases. However, there are 2 circumstances in which a more accurate imaging method is necessary: condemonstrate tl fusing images in conventional studies and persistent low 18 FDG-PET/CT human chorionic gonadotropin (hCG) values. Eighteen-fluoro-2-deoxyglucose-positron emission tomography/ computed tomography (18 FDG-PET/CT) can be helpful in these cases.

Gestational trophoblastic neoplasia: clinical trends in 8 years at Hospital Universitario de Caracas.

Objective: To analyze the clinical trends of gestational trophoblastic neoplasia (GTN) at the Department of Obstetrics and Gynecology, Hospital Universitario de Caracas (HUC).

Study Design: A medical record review was performed of epidemiologic, clinical and diagnostic features of 25 cases of GTN at HUC from 1997 to 2004.

Results: During the study period, 35,300 deliveries occurred, and 25 patients were diagnosed with GTN; the prevalence was 0.

Gestational trophoblastic disease in ectopic pregnancy: A case series.

Objective: To describe 6 cases of gestational trophoblastic disease (GTD) in ectopic pregnancy admitted to Hospital Universitario de Caracas (HUC).

Study Design: Medical records of 6 patients admitted to the Obstetrics and Gynecology Department, HUC, from 1996 to 2004 were reviewed. They underwent surgery with a diagnosis of ectopic pregnancy, and histologic analysis revealed GTD.