追踪剖腹产 - 后腹孕期热囊细胞新生病链接
Gabriela Paiva1, Antônio Braga, Solange Artimos de Oliveira
1Department of Maternal and Child Health, Postgraduate Program in Medical Sciences, School of Medicine, Fluminense Federal University, Niterói, the Department of Gynecology and Obstetrics, School of Medicine, Maternity School, Federal University of Rio de Janeiro, Rio de Janeiro, the Postgraduate Program in Applied Health Sciences, University of Vassouras, Vassouras, the Department of Obstetrics, Paulista School of Medicine, Federal University of São Paulo (EPM-UNIFESP), São Paulo, the Botucatu Trophoblastic Disease Center, Botucatu Medical School Hospital, the Department of Gynecology and Obstetrics, Postgraduation Program in Tocogynecology UNESP-São Paulo State University, Botucatu, and the Hospital Moinhos de Vento, Porto Alegre, Brazil; the Section of Gynecologic Oncology, Obstetrics and Gynecology Institute, Taussig Cancer Institute, Lerner Research Institute, Cleveland Clinic Foundation, Cleveland, Ohio; and the New England Trophoblastic Disease Center, Division of Gynecologic Oncology, Department of Obstetrics, Gynecology and Reproductive Biology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts.
剖腹产史增加了45%的 postmolar 妊娠 trofhoblastic 瘤的风险. 这一发现支持目前的管理,但建议增加对先前剖腹产患者的警.
科学领域:
- 妇科 妇科 妇科 妇科
- 在瘤学瘤学.
- 生殖医学 生殖医学
背景情况:
- 孕期 trofhoblastic 瘤 (GTN) 可以在水性形分子发生后出现.
- 剖腹产是常见的产科手术,具有潜在的长期影响.
- 前剖腹产与GTN风险之间的关联尚未得到充分证实.
研究的目的:
- 调查剖腹产病史是否会影响患上乳头后妊娠 trofhoblastic 瘤的风险.
- 要确定剖腹产史是否影响GTN.的临床攻击性或化疗抵抗性.
主要方法:
- 在两个国际GTD参考中心进行的回顾性队列研究.
- 对2904名水性形病患者的分析,比较了以前剖腹产和没有剖腹产的患者.
- 多变量后勤回归用于识别后骨GTN和化学抵抗的预测因子.
主要成果:
- 在剖腹产前的分娩独立地与45%的后骨GTN风险增加有关 (aOR1.45).
- 之前剖腹产的数量或指示并没有显著改变这种风险.
- 剖腹产史与低风险GTN患者的化学抵抗增加没有相关性.
结论:
- 剖腹产的病史是发展后GTN的危险因素.
- 这些发现支持目前的GTN监控协议.
- 患有先前剖腹产的患者在脊柱后监测期间需要提高临床警.
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