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GTN contraception

Patrícia Rangel Sobral Dantas, Izildinha Maestá, Jorge Rezende Filho, Joffre Amin Junior, Kevin M Elias, Neil Howoritz, Antonio Braga, Ross S Berkowitz
OBJECTIVE: To evaluate the influence of hormonal contraception (HC) on the development and clinical aggressiveness of gestational trophoblastic neoplasia (GTN) and the time for normalization of human chorionic gonadotropin (hCG) levels. METHODS: A retrospective cohort study was conducted with women diagnosed with molar pregnancy, followed at the Rio de Janeiro Trophoblastic Disease Center, between January 2005 and January 2015. The occurrence of postmolar GTN and the time for hCG normalization between users of HC or barrier methods (BM) during the postmolar follow-up or GTN treatment were evaluated...
November 2017: Gynecologic Oncology
A Braga, I Maestá, D Short, P Savage, R Harvey, M J Seckl
OBJECTIVE: To re-evaluate the safety of hormonal contraceptives (HC) after uterine evacuation of complete hydatidiform mole (CHM). DESIGN: Historical database review. SETTING: Charing Cross Hospital Gestational Trophoblastic Disease Centre, London, United Kingdom. POPULATION: 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...
July 2016: BJOG: An International Journal of Obstetrics and Gynaecology
Jun Zhao, Yang Xiang, Lina Guo, Xirun Wan, Fengzhi Feng, Tong Ren
OBJECTIVE: To approach the efficiency and feasibility of preserving the fertility for patients with placental site trophoblastic tumor (PSTT). METHODS: Totally 2 086 cases of gestational trophoblastic neoplasm (GTN) patients registered in Peking Union Medical College Hospital between 1998 and 2013. Fifty-seven of them were PSTT patients, 40 cases of which suffered hysterectomy, the rest 17 PSTT patients who preserved their fertility were analyzed retrospectively...
April 2014: Zhonghua Fu Chan Ke za Zhi
Ao Igwegbe, Gu Eleje
BACKGROUND: Hydatidiform mole (molar pregnancy) is the pre-malignant form of gestational trophoblastic neoplasia. It is of clinical and epidemiological interest because of its significant complication in pregnancy. AIM: This study was to determine the incidence, risk factors, clinical presentations, diagnosis, treatment options, and outcomes of molar pregnancy in a Nigerian tertiary health institution. MATERIALS AND METHODS: A 10-year retrospective study of patients with molar pregnancy managed at the hospital from 1(st) July 2001 to 30(th) June 2010 was undertaken...
April 2013: Annals of Medical and Health Sciences Research
Dorota Jenerowicz, Adriana Polańska, Karolina Olek-Hrab, Wojciech Silny
Transdermal therapeutic systems (TTS) belong to the widely used methods of drug administration, which allow rate-controlled drug delivery and avoidance of first-pass metabolism in the liver Beside scopolamine, nitroglycerin (glyceryl trinitrate), nicotine, clonidine and fentanyl, also transdermal delivery of sex steroids for hormone replacement therapy and contraception is a well-known and popular method in daily clinical practice. It is estimated that approximately 20% of patients using transdermal estradiol may complain of adverse cutaneous side effects...
January 2012: Ginekologia Polska
K Y Tse, Hextan Y S Ngan
Most women with gestational trophoblastic disease are of reproductive age. Because the disease is readily treatable with favourable prognosis, fertility becomes an important issue. Hydatidiform mole is a relatively benign disease, and most women do not require chemotherapy after uterine evacuation. A single uterine evacuation has no significant effect on future fertility, and pregnancy outcomes in subsequent pregnancies are comparable to that of the general population, despite a slight increased risk of developing molar pregnancy again...
June 2012: Best Practice & Research. Clinical Obstetrics & Gynaecology
B Thirumagal, D Sinha, R Raghavan, N Bhatti
This study was conducted to assess the management of gestational trophoblastic diseases (GTN) in a district general hospital in accordance with the RCOG guidelines. A retrospective case notes review over a 5-year period found a total of 23 patients treated in this hospital. The annual incidence of hydatidiform mole was 1.3/1,000 deliveries (3,500 deliveries per annum). Ultrasound scanning diagnosed or suspected GTN in only nine of the 23 cases (39%); six women (26%) were diagnosed as missed miscarriage and another six (26%) were diagnosed as incomplete miscarriage...
July 2009: Journal of Obstetrics and Gynaecology: the Journal of the Institute of Obstetrics and Gynaecology
A H El-Shalakany, K M Kamel, A M Ismail, L Salah, S S El-Deen Fahmy, E El-Deen Ammar
The purpose of this study is to evaluate the immunohistochemical detection of telomerase enzyme and estrogen receptor (ER) and progesterone receptor (PGR) in gestational trophoblastic neoplasia (GTN) and its clinical significance. Formalin-fixed paraffin blocks for 30 patients (24 with molar pregnancy, 3 with choriocarcinoma, and 3 with placental site trophoblastic tumor) as cases and six products of conception samples from patients with incomplete abortion as controls were included in the study. Immunohistochemical detection of the telomerase catalytic protein and ER and PGR was carried out using streptavidin-biotin-peroxidase method...
September 2006: International Journal of Gynecological Cancer
Helio L F F Costa, Pat Doyle
OBJECTIVE: Controversy exists regarding the use of oral contraceptives following hydatidiform mole and possible increased risk of persistent trophoblastic neoplasia. The purpose of this study is to perform a systematic review of the literature to assess the evidence for and against a possible link between oral contraceptive use and the need for chemotherapy after molar evacuation. METHODS: We searched the computerized databases MEDLINE, EMBASE, Popline, Web of Sciences, LILACS and the Cochrane Controlled Trials Register, ISI Proceedings, performed a hand search of references and wrote to experts to identify randomized controlled trials and observational studies comparing oral contraceptives with other methods of contraception...
March 2006: Gynecologic Oncology
T Y Ng, L C Wong
The FIGO Committee Report on the FIGO 2000 staging for gestational trophoblastic disease included criteria for the diagnosis of gestational trophoblastic neoplasia (GTN). It recommended investigative tools for diagnosing metastases. Anatomical and prognostic indicators were combined into a stage : risk score to stratify patients into low and high-risk groups. This is the first staging system to incorporate inclusive criteria that are likely to be adopted universally. The diagnostic evaluation of GTN is presented...
December 2003: Best Practice & Research. Clinical Obstetrics & Gynaecology
Stephen James Steigrad
The epidemiology of gestational trophoblastic diseases is unclear. Problems with collection and interpretation of differing data abound. Hydatidiform mole (HM) is associated with abnormal gametogenesis and/or fertilization. This is further influenced by age, ethnicity and a prior history of an HM suggesting a genetic basis for its aetiology. Whilst a prior HM is significant in the development of trophoblastic neoplasia there is no clear explanation for the development of gestational trophoblastic neoplasia in association with a normal gestation...
December 2003: Best Practice & Research. Clinical Obstetrics & Gynaecology
Navid Esfandiari, Jeffrey M Goldberg
BACKGROUND: Persistently false positive human chorionic gonadotropin (hCG) test results in the absence of an intrauterine pregnancy may lead to a diagnosis of ectopic pregnancy or gestational trophoblastic neoplasia and unnecessary testing and therapy. CASE: A 38-year-old woman on oral contraceptives and a 53-year-old perimenopausal woman presented with persistently elevated serum beta-hCG levels from 30 to 225 mIU/mL. Both women had a history of working with mice...
May 2003: Obstetrics and Gynecology
Morten B Sorensen, Peter Collins, Paul J L Ong, Carolyn M Webb, Christopher S Hayward, Elizabeth A Asbury, Peter D Gatehouse, Andrew G Elkington, Guang Z Yang, Ali Kubba, Dudley J Pennell
BACKGROUND: Depot medroxyprogesterone acetate (DMPA) inhibits proliferation of ovarian follicles, resulting in anovulation and a decrease in circulating estrogen; the latter action is potentially disadvantageous to cardiovascular health. We therefore investigated the vascular effects of long-term contraceptive DMPA in young women. METHODS AND RESULTS: Endothelium-dependent (hyperemia-induced flow-mediated dilatation [FMD]) and -independent (glyceryl trinitrate [GTN]) changes in brachial artery area were measured using cardiovascular magnetic resonance in 13 amenorrheic DMPA users (>1 year use; mean age 29+/-4 years) and in 10 controls (mean age 30+/-4 years, P=0...
September 24, 2002: Circulation
M Lember, A Pikk, K Mattila, I Virjo, R Kermes, M Isokoski
OBJECTIVE: To compare ratings of the necessity of drugs in the daily practice of experienced primary care doctors in Estonia and Finland to find out the differences and similarities in the therapeutic traditions of the two different societies. METHODS: A questionnaire was sent to all Estonian district doctors born in the 1940s and to all Finnish specialized general practitioners born in the 1940s, who then evaluated the necessity of the listed drugs on a visual analogue scale...
1997: European Journal of Clinical Pharmacology
M L Messerli, A M Lilienfeld, T Parmley, J D Woodruff, N B Rosenshein
A case-control study to determine the gynecologic and reproductive risk factors for gestational trophoblastic neoplasia was conducted in the Baltimore Metropolitan Area. All cases (N = 190) that were pathologically diagnosed from 1975 to 1982 as hydatidiform mole, invasive mole, or choriocarcinoma were ascertained. Slides were independently reviewed by two pathologists. Cases were matched by age, race, and last menstrual period to controls who were delivered of normal pregnancies at term. In the analysis of medical record and interview data, factors found to be positively associated with gestational trophoblastic neoplasia included professional occupations (odds ratio = 2...
October 1, 1985: American Journal of Obstetrics and Gynecology
H Askmark, P O Lundberg, S Olsson
A survey was made of 10,506 reports to the WHO Collaboration Centre for International Drug Monitoring from five countries concerning headache, migraine, aggravated migraine and intracranial hypertension associated with drugs. The ten drugs most frequently reported to be associated with headache were indomethacin, nifedipine, cimetidine, atenolol, trimethoprim-sulphamethoxazole, zimeldine, glyceryl trinitrate, isosorbide dinitrate, zomepirac and ranitidine. Regarding migraine, oral contraceptives were also among the most implicated drugs...
July 1989: Headache
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