A STUDY OF GESTATIONAL TROPHOBLASTIC DISEASE

Getational Trophoblastic Disease

Abstract

Objective: To study the frequency, type of mole and follow –up of patients of gestational trophoblastic disease.
Study Design:Descriptive study.
Setting and Duration: Military Hospital Rawalpindi (Tertiary Care hospital) from Jan 2001 to Dec 2006.
Patients and Method: Ninety Patients both primigravida and multigravida were recruited by convenience sampling. They did not have any associated disease. The frequency regarding age, parity, blood group and antecedent pregnancy was calculated. They were managed initially by suction curettage ad later either expectantly or actively. Type of mole was confirmed by histopathology report. Follow-up of these patients was done by clinical symptoms, β-hCG level, x-ray chest and ultrasound abdomen and pelvis.
Results: GTD included 31.11% patients aged <40 years and 68.88% patients aged >40 years. 55.55% of patients had blood group O and only 33.33% patient with other blood groups. In 64.44% patients previous pregnancy was miscarriage while only 6.66% patients had term pregnancy before. 77.77% patients presented with vaginal bleeding, while cough, gastro-intestinal symptoms and hemorrhage included 4.44% and 5.55% patients respectively. The serum β-hCG level dropped to <10,000 U/L in 65.55% patients within 6 months while 34.44% patients had persistently raised serum β -hCG level. Histopathological reports of 80% patient revealed complete mole while 20% patients had partial mole. Frequency of malignancy was found mostly in patients of complete mole. Chemotherapy was given to 38.88% patients among them 24.44% treated with single agent and 14.44% patients were given multi-drug therapy.
Conclusion: GTD is more common in multigravida than primigravida. High frequency was observed in extremes of reproductive life and with blood group O. Irregular vaginal bleeding is the most common clinical feature. The frequency of complete mole is more than partial mole.