Cristina Laguna Benetti-Pinto

Asymptomatic postmenopausal women: what are the risk factors for endometrial malignancies? A multicentric retrospective study

To evaluate the prevalence and risk factors for endometrial malignancies in asymptomatic postmenopausal women. Multicentric retrospective analytical study in two Brazilian Reference Centers. All women without postmenopausal bleeding who were submitted to hysteroscopy with biopsy were included (1665). Excluded women without anatomopathological results (625) and whose medical records were incomplete (37). The variables analyzed were age; parity; body mass index; duration of menopausal status; systemic arterial hypertension; diabetes mellitus; use of hormone replacement therapy; use of tamoxifen; duration of use of tamoxifen; endometrial thickness and biopsy results. The frequency of endometrial malignancies in asymptomatic postmenopausal women was 2.39%. Endometrial thickness ≥8 mm increased the chance of endometrial malignancies, even more, with an endometrial thickness ≥12.55 mm the chance of endometrial malignancies increased by 4.68 times ( The prevalence of endometrial malignancies was low and the only risk factor for endometrial malignancies in asymptomatic postmenopausal women was endometrial thickness.

Evaluation of the effectiveness of hysteroscopic myomectomy in the symptoms of women with uterine myomatosis: a retrospective cohort

SUMMARY OBJECTIVE: The aim of this study was to evaluate the effectiveness of hysteroscopic myomectomy in the symptoms of women with uterine myomatosis. METHODS: This is a retrospective cohort study conducted on 119 women with uterine myomatosis who underwent hysteroscopic myomectomy in a tertiary hospital from 2018 to 2023. Women of reproductive age diagnosed with submucosal myoma who underwent hysteroscopic myomectomy were included, and women who did not have the data in their medical records necessary for completion were excluded. The sociodemographic and clinical variables of these women were evaluated. RESULTS: The average age of the women was 41.4±6.8 years. Among the fibroids, 37.0% were International Federation of Gynecology and Obstetrics (FIGO) 0 and 52.5% were FIGO 1. The average size of the fibroids was 2.7±1.4 cm. There were 10.0% of complications. After myomectomy, 67.2% of the women had improvement in symptoms, 66.1% opted for hormonal treatment, and 14.3% underwent hysterectomy. Ninety percent of the women who did not show improvement in symptoms had FIGO 1 and FIGO 2 fibroids (p=0.002), and 57% had a higher number of cesarean sections (p=0.038). In addition, 61% of these women required a new approach (p<0.001), and 93% opted for treatment after myomectomy (p<0.001). Factors associated with a greater chance of women's symptoms not improving were having more than two cesarean sections (hazard ratio [HR]=3.52, p=0.026), FIGO 1 fibroids (HR=5.75, p=0.003), and FIGO 2–3 fibroids (HR=8.25, p=0.030). CONCLUSION: Hysteroscopic myomectomy has a low complication rate, and having fibroids with a larger intramural component is the main factor responsible for myomectomy failure.

Psychological impact of gestational trophoblastic disease: a cross-sectional study

To evaluate the psychological repercussions of gestational trophoblastic disease. A cross-sectional study including 100 women (50 with gestational trophoblastic disease and 50 without) was conducted between September 2020 and October 2021. Socio-demographic characteristics, quality of life, depression, and anxiety were evaluated and follow-up was performed at a referral center. Women with gestational trophoblastic disease had a mean age and body mass index of 28.8±6.4 years and 24.7±5.0kg/m2, respectively; the corresponding values for the Control Group were 30.1±6.9 years (p=0.27) and 28.9±4.6kg/m2 (p<0.001). The Gestational Trophoblastic Disease Group presented a better general health status (p=0.04) than the Control Group. Among women with gestational trophoblastic disease, 62% and 46% had anxiety and depression, respectively; the corresponding percentages for women without gestational trophoblastic disease were 52% and 24% (p=0.64 and 0.08, respectively). Multidisciplinary follow-up at a referral center may improve the mental health and quality of life scores of women with gestational trophoblastic disease.

Assessment of risk factors associated with post-molar gestational trophoblastic neoplasia: a retrospective cohort

Evaluate the risk factors for the development of post-molar gestational trophoblastic neoplasia. Retrospective cohort study with 320 women with gestational trophoblastic disease (GTD) followed in a tertiary hospital from January 2005 to January 2020. Data referring to the women's sociodemographic profile, clinical, laboratory and treatment aspects and types of GTD were analyzed. The mean age of women with the benign form was 26.4±8.6 years and with the malignant forms 26.9±8.5 years (p=0.536). Most women with malignant forms came from regions further away from reference center (p=0.012), had vesicle elimination at the time of diagnosis (p=0.028) and needed more than one uterine evacuation (p<0.001) when compared to the benign forms. There was no difference between laboratory tests in both forms. Being between 30 and 39 years old increased the chance of developing invasive mole by 2.5 (p=0.004; 95%CI:1.3-4.9) and coming from regions far from reference center by 4.01 (p=0.020; CI95%: 1.2-12.9). The women with the highest risk of malignant forms were those with the longest time of become normal on human gonadotrophic hormone (hCG) testing (each week the risk increases 1.3 times; p<0.001, 95%CI: 1.2-1.3). The prolonged hCG fall curve is the main indicator of an increased chance of GTN. Women from regions further away from reference center have a greater chance of developing malignant forms, probably due to the difficulty in accessing the reference center and, therefore, adequate follow-up that would allow early identification of more serious cases.