Fundamentos do diagnóstico e tratamento da gravidez molar
Palavras-chave:
Doença trofoblástica gestacional, mola hidatiforme, gravidezResumo
A gravidez molar, entidade clínica benigna da doença trofoblástica gestacional (DTG), é uma anomalia que afeta uma a cada 200 a 400 gestações em mulheres brasileiras, o que corresponde a uma incidência 5 a 10 vezes maior do que a encontrada nos Estados Unidos e na Europa. Esta rara afecção gestacional tem predileção pelos extremos reprodutivos, ocorre em razão da fertilização anormal e apresenta-se sob duas formas clínicas distintas: mola hidatiforme completa e mola hidatiforme parcial. A gonadotrofina coriônica humana, o marcador biológico e tumoral dessa doença, é útil para o diagnóstico, monitoramento e seguimento das pacientes acometidas por esse trofoblastoma, devendo ser dosada semanalmente após o esvaziamento uterino, para acompanhamento adequado e diagnóstico precoce de evolução maligna para neoplasia trofoblástica gestacional. Os principais desafios para tratamento de pacientes com gravidez molar abrangem o diagnóstico precoce, esvaziamento uterino imediato e seguimento pós-molar sistemático, melhorando assim o prognóstico das pacientes, sua qualidade de vida e resultados reprodutivos. É imprescindível que todo esse processo aconteça em centros de referência, onde existem equipes preparadas para o melhor atendimento e acompanhamento dessas pacientes. A atualização das estratégias diagnósticas e terapêuticas envolvidas no tratamento da DTG, foco deste trabalho, tem por objetivo melhorar esse cenário, contribuindo para o maior conhecimento sobre o assunto pela comunidade médica.
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