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妊娠滋养细胞疾病患者的情绪和临床观察:多学科行动。

Emotional and Clinical Aspects Observed in Women with Gestational Trophoblastic Disease: A Multidisciplinary Action.

机构信息

Universidade Federal de Ciências da Saúde de Porto Alegre, Porto Alegre, RS, Brazil.

Irmandade da Santa Casa da Misericórdia de Porto Alegre, Porto Alegre, RS, Brazil.

出版信息

Rev Bras Ginecol Obstet. 2022 Apr;44(4):343-351. doi: 10.1055/s-0042-1742681. Epub 2022 Feb 9.

Abstract

OBJECTIVE

To evaluate the emotional and clinical aspects observed in women with gestational trophoblastic disease (GTD) followed-up in a reference center (RC) by a multidisciplinary team.

METHODS

Retrospective cohort study of the clinical records of 186 women with GTD and of the emotional aspects (EA) observed in these women by a team of psychologists and reported by the 389 support groups conducted from 2014 to 2018.

RESULTS

The women were young (mean age: 31.2 years), 47% had no living child, 60% had planned the pregnancy, and 50% participated in two or more SG. Most women (n = 137; 73.6%) reached spontaneous remission of molar gestation in a median time of 10 weeks and had a total follow-up time of seven months. In the group of 49 women (26.3%) who progressed to gestational trophoblastic neoplasia (GTN), time to remission after chemotherapy was 18 weeks, and total follow-up time was 36 months. EA included different levels of anxiety and depression, more evident in 9.1% of the women; these symptoms tended to occur more frequently in women older than 40 years ( = 0.067), less educated ( = 0.054), and whose disease progressed to GTN ( = 0.018), as well as in those who had to undergo multi-agent chemotherapy ( = 0.028) or hysterectomy ( = 0.001) adjuvant to clinical treatment.

CONCLUSION

This study found several EA in association with all types of GTD. It also highlights the importance of specialized care only found in a RC, essential to support the recovery of the mental health of these women.

摘要

目的

评估由多学科团队在参考中心(RC)随访的妊娠滋养细胞疾病(GTD)女性的情绪和临床方面。

方法

对 2014 年至 2018 年期间进行的 186 例 GTD 女性的临床记录和由心理学家团队观察到的情绪方面(EA)进行回顾性队列研究,并由 389 个支持小组进行报告。

结果

这些女性年轻(平均年龄:31.2 岁),47%没有活产子女,60%计划怀孕,50%参加了两个或更多个 SG。大多数女性(n=137;73.6%)在中位数 10 周内自发缓解葡萄胎妊娠,并进行了为期七个月的总随访。在 49 例(26.3%)进展为妊娠滋养细胞肿瘤(GTN)的女性中,化疗后缓解时间为 18 周,总随访时间为 36 个月。EA 包括不同程度的焦虑和抑郁,在 9.1%的女性中更为明显;这些症状在年龄大于 40 岁的女性中(=0.067)、受教育程度较低的女性中(=0.054)、疾病进展为 GTN 的女性中(=0.018)以及需要接受多药化疗的女性中(=0.028)或辅助临床治疗的子宫切除术(=0.001)中更为常见。

结论

本研究发现与所有类型的 GTD 相关的几种 EA。它还强调了仅在 RC 中才能提供的专业护理的重要性,这对支持这些女性的心理健康恢复至关重要。

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本文引用的文献

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Gestational trophoblastic neoplasia lethality among Brazilian women: A retrospective national cohort study.
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Challenges in the diagnosis and treatment of gestational trophoblastic neoplasia worldwide.
World J Clin Oncol. 2019 Feb 24;10(2):28-37. doi: 10.5306/wjco.v10.i2.28.
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Update on the diagnosis and management of gestational trophoblastic disease.
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