Background: Gestational Trophoblastic Disease (GTD) is a spectrum of interrelated conditions but histologically distinct disease entities originating from placenta. It can be associated with significant morbidity and mortality in the absence of timely and proper intervention.
Objective: The main objective of this study was to assess magnitude of gestational Trophoblastic disease and associated factors in Hawassa University Comprehensive Specialized Hospital.
Methods: A five-year retrospective cross-sectional study was conducted in Hawassa University Comprehensive Specialized Hospital, Southern Ethiopia from September 11, 2012 to September 11, 2017. The medical records of patients managed for GTD and the total number of deliveries during the study period were retrieved. There was a total of 16,957 deliveries and 194 Gestational trophoblastic cases. The data were entered with Epi data version 3.1statistical software and exported to Statistical Package for Social Sciences version 22.0 for analysis
Results: The magnitude of gestational trophoblastic disease was 11.4%. Gestational trophoblastic disease was diagnosed in the first pregnancy 15.5% of cases and 40.2% between para one and four. Vaginal bleeding was the most common presenting symptom 87.1% and 46.4% patients had anemia at admission and 26.3% of patients were transfused with blood. Hydatidiform mole was the commonest disease accounting for 90.2%. Suction curettage was the commonest treatment modality 70.8%. Having history of GTD, hyperemesis gravidarum, respiratory symptoms and not referred cases had a statistically significant association with occurrence of hydatidiform mole. 7.7% of patients had remission, persistent GTD developed in 4.1% cases
Conclusion: The burden of Gestational Trophoblastic Disease is persistently high in the study area. Majority of the patients were not followed as per standard after management as a result their final outcome is not known for the majority of the cases.
Keyword: Gestational trophoblastic disease, molar pregnancy, hydatidiform mole, choriocarcinoma, Ethiopia
1. Soper, J.T., D.G. Mutch, and J.C. Schink. Diagnosis and treatment of gestational trophoblastic disease: ACOG Practice Bulletin No. 53. Gynecologic oncology, 2004. 93(3): p. 575-585.
2. Wairachpanich, V., S. Limpongsanurak, and R. Lertkhachonsuk, Epidemiology of Hydatidiform Moles in a Tertiary Hospital in Thailand over Two Decades: Impact of the National Health Policy. Asian Pac J Cancer Prev, 2015. 16(18): p. 8321-8325.
3. Yakasai, I., I. Abubakar, and Y. Eze, Gestational trophoblastic disease in a teaching hospital in Northern Nigeria. Am J Bio Sci, 2015. 3(1): p. 7-10.
4. Dobson, L., et al., The presentation and management of post-partum choriocarcinoma. British journal of cancer, 1999. 79(9-10): p. 1531.
5. Khashoggi, T.Y., Prevalence of gestational trophoblastic disease. A single institution experience. Saudi medical journal, 2003. 24(12): p. 1329-1333
6. Negussie, D. and T. Belachew, Profile of Gestational Trophoblastic Diseases in Two Teaching Hospitals, Addis Ababa, Ethiopia. Ethiopian Journal of Health Sciences, 2008. 18(1)
7. Khaskheli, M., et al., Gestational trophoblastic disease: experience at a tertiary care hospital of Sindh. J Coll Physicians Surg Pak, 2007. 17(2): p. 81-83.
8. Stevens, F., et al., Gestational trophoblastic disorders: an update in 2015. Geburtshilfe und Frauenheilkunde, 2015. 75(10): p. 1043.
9. Boufettal, H., et al., Complete hydatiforme mole in Morocco: epidemiological and clinical study. Journal de gynecologie, obstetrique et biologie de la reproduction, 2011. 40(5): p. 419-429.
10. Escobar, P.F., et al., Treatment of high-risk gestational trophoblastic neoplasia with etoposide, methotrexate, actinomycin D, cyclophosphamide, and vincristine chemotherapy. Gynecologic oncology, 2003. 91(3): p. 552-557.
11. Ngan, H., et al., Update on the diagnosis and management of gestational trophoblastic disease. International Journal of Gynecology & Obstetrics, 2015. 131(S2)
12. Oum, A., Clinical analysis of molar pregnancy in Egyptian population. Al-Azhar Assiut Medical Journal, 2014. 12.
13. Fu, J., et al., Prophylactic chemotherapy for hydatidiform mole to prevent gestational trophoblastic neoplasia. The Cochrane Library, 2012
14. Fatima, M., et al., Incidence, management, and outcome of molar pregnancies at a tertiary care hospital in quetta, pakistan. ISRN obstetrics and gynecology, 2011. 2011.
15. Kolawole, A.O., et al., Gestational trophoblastic disease in Abuth Zaria, Nigeria: A 5-year review. Tropical Journal of Obstetrics and Gynaecology, 2016. 33(2): p. 209.
16. gwegbe, A. and G. Eleje, Hydatidiform mole: a review of management outcomes in a tertiary hospital in South-East Nigeria. Annals of medical and health sciences research, 2013. 3(2): p. 210
17. Igwegbe, A. and G. Eleje, Hydatidiform mole: a review of management outcomes in a tertiary hospital in South-East Nigeria. Annals of medical and health sciences research, 2013. 3(2): p. 210
18. Al-Talib, A.A., Clinical presentation and treatment outcome of molar pregnancy: Ten years experience at a Tertiary Care Hospital in Dammam, Saudi Arabia. Journal of family & community medicine, 2016. 23(3): p. 161
19. Kaye, D.K., Gestational trophoblastic disease following complete hydatidiform mole in Mulago Hospital, Kampala, Uganda. African health sciences, 2002. 2(2): p. 47-51.