Postmolar surveillance at a trophoblastic disease center that serves indigent women

Am J Obstet Gynecol. 2003 May;188(5):1151-3. doi: 10.1067/mob.2003.297.

Abstract

Objective: The purpose of this study was to determine compliance with postmolar pregnancy surveillance in our indigent population.

Study design: Data for all women who were diagnosed with molar pregnancy from January 1996 through December 2000 were entered prospectively into a database. After remission, postmolar pregnancy surveillance was continued for 6 months. Patients whose condition required chemotherapy for gestational trophoblastic tumor had 12 months of follow-up. Medical records were reviewed.

Results: Molar pregnancies occurred in 121 women: 103 Hispanic women (85%), 12 African American women (10%), and 6 white women (5%). Eighty-two women (68%) achieved remission without chemotherapy; 23 women (19%) were lost to follow-up without achieving remission, and 16 women (13%) had gestational trophoblastic tumor. Fifty-six Hispanic women (54%) completed postmolar pregnancy surveillance, compared with two African American women (11%, P <.01). Hispanic patients who were fluent in Spanish only were more likely to complete follow-up than bilingual Hispanic patients (62% vs 41%, P <.01).

Conclusion: Hispanic women who were fluent in Spanish only were most likely to complete the recommended postmolar human chorionic gonadotropin surveillance.

MeSH terms

  • Adolescent
  • Adult
  • Antibiotics, Antineoplastic / therapeutic use
  • Antimetabolites, Antineoplastic / therapeutic use
  • Black or African American / statistics & numerical data
  • Dactinomycin / therapeutic use
  • Female
  • Hispanic or Latino / statistics & numerical data
  • Humans
  • Hydatidiform Mole* / drug therapy
  • Hydatidiform Mole* / epidemiology
  • Hydatidiform Mole* / ethnology
  • Methotrexate / therapeutic use
  • Patient Compliance / statistics & numerical data*
  • Population Surveillance*
  • Poverty*
  • Pregnancy
  • Prospective Studies
  • Retreatment
  • Texas
  • Uterine Neoplasms* / drug therapy
  • Uterine Neoplasms* / epidemiology
  • Uterine Neoplasms* / ethnology
  • White People / statistics & numerical data

Substances

  • Antibiotics, Antineoplastic
  • Antimetabolites, Antineoplastic
  • Dactinomycin
  • Methotrexate