Reda Hemida

Mansoura University

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Eman Toson

Mansoura University

Helena C. van Doorn

Erasmus MC Cancer Institute

Rima Slim

McGill University Health Centre

Maryam Rezaei

University of Münster

Mohammad Arafa

Sultan Qaboos University

Majid Fardaei

Shiraz University of Medical Sciences

Rashmi Bagga

Post Graduate Institute of Medical Education and Research

Philippe Sauthier

Centre Hospitalier de l’Université de Montréal

Sujatha Jagadeesh

Fetal Care Research Foundation

Mónica Aguinaga‐Ríos

Instituto Nacional de Perinatología

Cooperative Institutions

Mansoura University

Mansoura University Hospital

McGill University Health Centre

McGill University

King Abdulaziz University

Woman's Hospital

Alexandria University

Zagazig University

University College London

Charité - Universitätsmedizin Berlin

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Novel pathogenic variants in NLRP7, NLRP5, and PADI6 in patients with recurrent hydatidiform moles and reproductive failure

Clinical Genetics (2021)

Maryam Rezaei Beena Suresh Eric Bereke Zahra Hadipour Mónica Aguinaga‐Ríos

Abstract Recurrent hydatidiform moles (RHMs) are human pregnancies with abnormal embryonic development and hyperproliferating trophoblast. Biallelic mutations in NLRP7 and KHDC3L, members of the subcortical maternal complex (SCMC), explain the etiology of RHMs in only 60% of patients. Here we report the identification of seven functional variants in a recessive state in three SCMC members, five in NLRP7 , one in NLRP5, and one in PADI6 . In NLRP5 , we report the first patient with RHMs and biallelic mutations. In PADI6 , the patient had four molar pregnancies, two of which had fetuses with various abnormalities including placental mesenchymal dysplasia and intra‐uterine growth restriction, which are features of Beckwith‐Wiedemann syndrome and Silver Russell syndrome, respectively. Our findings corroborate recent studies and highlight the common oocyte origin of all these conditions and the continuous spectrum of abnormalities associated with deficiencies in the SCMC genes.

10.1111/cge.13941

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Citations (27)

Second Uterine Curettage and the Number of Chemotherapy Courses in Postmolar Gestational Trophoblastic Neoplasia

Obstetrics and Gynecology (2019)

Reda Hemida Elvira L. Vos Basem Eldeek Mohammad Arafa Eman Toson

To investigate the effect of second uterine curettage on the number of chemotherapy courses and relapse rate in low-risk postmolar gestational trophoblastic neoplasia.In a phase III trial, patients with low risk gestational trophoblastic neoplasia were randomised (1:1) to a second curettage or no curettage group before methotrexate treatment. Eligibility criteria were serum human chorionic gonadotropin (hCG) level 5,000 international units/L or less and fit for treatment with methotrexate. Exclusion criteria were previous uterine perforation and life-threatening bleeding. With a two-sided 5% significance level and a power of 99%, a sample size of 44 patients per group was necessary to detect a mean reduction in 2.3 chemotherapy courses. The primary outcome was the number of chemotherapy courses required for hCG normalization. Secondary outcomes were needed for second-line treatment, toxicity, relapse rates, and variables associated with number of chemotherapy courses.From October 2011 through February 2016, 89 patients entered the study at the Mansoura Trophoblastic Clinic; in each group, 43 patients were included in the intention-to-treat analyses. Surgical complications did not occur. The mean number of chemotherapy courses required to reach hCG normalization was 4.4±2.2 SD in the control group vs 3.8±2.3 SD in the intervention group (P=.14). Groups were comparable in terms of second-line treatment needed to reach hCG normalization, and relapse within the first year. Only hCG levels related to the number of chemotherapy cycles required for hCG normalization.Second uterine curettage did not reduce the number of chemotherapy courses required or affect relapse rate in patients with low-risk postmolar gestational trophoblastic neoplasia.Dutch Trial Registry, NTR3390.

Curettage

Dilation and curettage

Uterine perforation

Human chorionic gonadotropin

10.1097/aog.0000000000003232

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Citations (19)

Collaboration Benefits All

JCO Global Oncology (2020)

Reda Hemida Helena C. van Doorn Leon F.A.G. Massuger

Most women facing gynecologic cancer live in countries with inadequate health systems, and treatment is rarely in line with international standards.This is particularly true in cervical cancer, because most developing countries offer few opportunities for radiotherapy, leaving many women without proper treatment and the risk of avoidable mortality. 1The Lancet recently highlighted the need to close the global cancer divide for women, but real progress will require not only evidence-based policy making but also broad multisectoral collaboration and innovative public health approaches to cancer care and control. 2 The gynecologic malignancy with the highest cure rate is gestational trophoblastic neoplasia (GTN).Postmolar GTN was studied at the Mansoura University Hospital, Mansoura, Egypt, with support from the Erasmus MC Cancer Institute, University Medical Center,

10.1200/jgo.19.00237

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Citations (1)

Misoprostol for Cervical Ripening Prior to Molar Evacuation: A letter to the editor

Journal of Obstetrics Gynecology and Cancer Research (2022)

Reda Hemida

10.30699/jogcr.7.4.356

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Citations (1)

Upfront Hysterectomy Versus Primary Chemotherapy in the Management of Low-Risk Gestational Trophoblastic Neoplasia at Old Age Patients: A Prospective Study

Indian Journal of Gynecologic Oncology (2024)

Medhat Othman Reda Hemida Ashraf A. Foda Mohamed Ibrahem Eid

Surgical oncology

Gestational trophoblastic neoplasia

10.1007/s40944-024-00801-4

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Citations (0)

Incidence of cesarean section among parturient women undergoing induced versus spontaneous labour per gestational weeks

Egyptian Journal of Health Care (2016)

Hala A. Ali Reda Hemida Azza Mohamed Hafez

Objective: To explore incidence of cesarean section among parturient women undergoing induced versus spontaneous labour per gestational weeks. Methods: An exploratory descriptive study was carried out at Labour and Delivery Ward at El Mansoura University Hospitals, Egypt. This study comprised a convenience sample of 100 pregnant women out of 130 randomized women who were admitted to Delivery Ward with induced or spontaneous labour with multi parae, low risk women with no pregnancy or medical complications or prior cesarean section, with 37-42 gestational weeks, singleton pregnancies and in vertex position. They were randomly assigned into two groups; a total of 60 women had an induction of labour and 40 went into spontaneous labour. Two tools were used: A structured interviewing questionnaire sheet was used to collect the maternal and neonatal characteristics such as; maternal age, parity, newborn weight and labour assessment sheet was used to assess vaginal versus cesarean section incidence according to onset of labour per gestational weeks and induction as well as augmentation methods for cesarean section. Results: Among 100 pregnancies that fulfilled the inclusion criteria, induced labour had more risk of cesarean section compared with spontaneous labour onset with statistical significant(p<0.001 in x2 test; OR 6.00; 95% confidence interval 2.453 – 14.678).The higher caesarean section rate in the induction group was seen from (38-41) weeks. On the other hand, the higher caesarean section rate was seen in the spontaneous group at 37 weeks and cervical ripening was the highest agent used in induced labour as well as oxytocin for spontaneous onset of labour. Conclusions and recommendation: In low risk multiparae women, induced labour has an increased risk of cesarean section compared with spontaneous onset labour per gestational weeks particularly when cervical ripening was required. Caesarean section incidence was higher in the induction group than spontaneous labour, it was seen from (38-41) gestational weeks. It should be prompt further and larger studies of the effect of induction of labour and its methods on caesarean section rate per gestational weeks.

10.21608/ejhc.2016.105192

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The impact of uterine re-curettage, pre-evacuation and week-one level of hCG on the number of chemotherapy courses in treatment of post molar GTN.

PubMed (2011)

Reda Hemida Eman Toson Helena C. van Doorn

Post molar GTN was reported to occur in 7.5-20% of patients following evacuation of complete hydatidiform moles and in 2.5-7.5% following evacuation of partial moles. The role of uterine re-curettage in post molar GTN is not clear.Study of the correlation of pre-evacuation and week- one level of hCG, and uterine re-curettage to the number of chemotherapy courses in treatment of post molar GTN.This retrospective study included 29 cases of post molar GTN through reviewing their medical records.There were 25 cases (86.21) of low risk, and 4 cases of high risk score (13.79%). The 3 year survival was 96.6%. There were non-significant correlation of age, parity, pre-evacuation level and hCG in week-1 to number of chemotherapy courses, while uterine re-curettage was significantly correlated to number of chemotherapy courses (p = 0.04).Uterine re-curettage was significantly correlated to less number of chemotherapy courses in patients with post molar GTN (p = 0.04). Pre-evacuation and week-1 hCG were not correlated to number of chemotherapy cycles. A large prospective randomized trial to clarify the beneficial effect of uterine re-curettage is recommended.

Curettage

Molar Pregnancy

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Citations (8)

“Oral L-Methyl Folate” May Substitute “Parenteral Folinic Acid” In The Methotrexate-Containing Chemotherapy Protocols In Low-Resource Countries: An Evidence-Based Review.

International Journal of Gynecological Cancer (2025)

Reda Hemida Dina Elghareeb Ghada Eladawi

Folinic acid

10.1016/j.ijgc.2024.101584

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P1240 Outcome of different treatment modalities for gestational trophoblastic neoplasia in women at 40 years old or above: a multicenter retrospective study

Reda Hemida Philippe Sauthier Eman Toson Nataliya Tsip Heru Pradjatmu

Introduction/Background

For treatment of GTN patients at old age; there is an ongoing debate about performing upfront hysterectomy to reduce tumor bulk or starting chemotherapy.

Methodology

A retrospective analysis of data from 5 referral centers from 5 countries (Egypt, Canada, Ukraine, Saudi Arabia, and Indonesia) during last 5 years. Medical records of 119 women with GTN were retrieved, reviewed and analyzed. Demographic criteria and outcome of different treatment strategies were evaluated.

Results

Mean age was 45.46 years, and median hCG was 1390.5 m.IU/ml. Low-risk GTN represented 81.5% of cases while 18.5% were in high-risk group. Most of the patients were in FIGO stage I (76.2%). Metastases were diagnosed in 28 cases (23.5%), lungs were commonest site. The commonest histopathological type was invasive mole (38.1%). Of 80 patients with low risk non metastatic GTN, 32 women were treated with single chemotherapy. Eighteen of them (56.2%) showed complete response while relapse was reported in one case. In 34 cases a hysterectomy was performed. In four; a wait and see policy was adopted while instant chemotherapy followed in 30, mainly single MTX for 1-12 courses. Only one case 1/34 (3%) failed to respond. Of 14 patients with low risk metastatic GTN, 8 women were treated with single chemotherapy while in 6 patients a hysterectomy was performed and MTX was started immediately in all. Complete response occurred only in 7/14 (50%). Two high risk patients died before treatment could start due to presence of distant metastases. Eleven cases had underwent hysterectomy and chemotherapy as first line; 7/11 showed complete response. Four women used EMA/CO combination chemotherapy alone; two of them (50%) had incomplete response and needed 2nd line EMA/EP combination.

Conclusion

Upfront hysterectomy for treatment low-risk non-metastatic disease and combination chemotherapy for high-risk disease were associated with better prognosis.

Disclosure

Nothing to disclose.

Gestational trophoblastic neoplasia

Medical record

10.1136/ijgc-2019-esgo.256

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Citations (0)

Can Revised Visual Inspection with Acetic Acid (VIA) Test Improve the Performance of Crude VIA Test of in Low-Resource-Setting Countries?

Indian Journal of Gynecologic Oncology (2017)

Amany A. Makroum Reda Hemida Yasser Mosbah Maher Shams Rafik Barakat

Surgical oncology

10.1007/s40944-017-0159-4

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Citations (0)