Abstract
Objectives. To study (1) the prevalence of different types of gestational trophoblastic neoplasia (GTN) in the local and nonlocal population of women at Al Wasl Hospital, a tertiary level referral centre for northern Emirates, (2) the safety of cervical preparation before uterine evacuation, (3) the role of repeat uterine evacuation in curing these cases, and (4) the percentage of cases ultimately requiring chemotherapy. Material and Methods. Retrospective analysis of case records of 35 women with diagnosis of gestational trophoblastic neoplasia were managed in the Department of Obstetrics and Gynecology at Al Wasl Hospital, over a 2-year period between January 2007 to December 2008. Results. 35 cases of gestational trophoblastic neoplasia were seen in a 2-year period (January 2007 to December 2008) at Al Wasl Hospital, with 7000 deliveries per year, prevalence being 1 in 400 live births. 60% cases were local Arabs. Histopathology revealed complete mole in 13 cases, partial mole in 17 cases, hydropic degeneration of villi in 4 cases, and no identifiable tissue in 1 case. No cases of choriocarcinoma or placental site trophoblastic tumour were seen during the study period. 34% cases received cervical preparation with prostaglandins prior to surgical curettage. Complications were minor. 62% were cured by primary suction curettage, 12% after second (repeat) uterine evacuation, and 25% needed single drug chemotherapy. 8% cases defaulted after primary evacuation and were lost to followup. Conclusions. Prevalence of GTN in the local Arab population is similar to other Asian populations. The majority of cases are cured by simple suction uterine curettage. Cervical preparation with prostaglandins should be done in selected cases to avoid perforation during evacuation. Second (repeat) uterine evacuation can be curative in some cases with strict selection criteria and avoid the need for chemotherapy. Regional registry of cases is needed to estimate the true incidence of this disease.
Highlights
Gestational trophoblastic neoplasia is excessive and inappropriate proliferation of trophoblast after the pregnancy has ended
We present a retrospective study of cases of gestational trophoblastic neoplasia (GTN) over a 2-year period that were managed at our hospital, which is a tertiary level teaching hospital
The prevalence of GTN among the Arab population appears to be similar to other Asians, and there is need for establishing a national registry to obtain the true incidence of the disease
Summary
Gestational trophoblastic neoplasia is excessive and inappropriate proliferation of trophoblast after the pregnancy has ended It includes a spectrum of disease from the benign hydatidiform mole (complete or partial mole), to the malignant gestational trophoblastic tumour (invasive mole, choriocarcinoma, and placental site trophoblastic tumour). It is a rare but important pregnancy-related disorder with an incidence of 1 in 400 in Asia and Latin America. The majority of cases can be cured by simple surgical intervention. Those cases requiring chemotherapy are generally cured with very low toxicity regimen. The curability of this condition is a milestone of success in the history of modern medicine
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
