Diagnostic and prognostic significance of serum beta hCG level in various gestational trophoblastic diseases

Abstract

Introduction: Gestational Trophoblastic Disease (GTD) is a term used for a group of pregnancy-related tumours. These consist of various tumours and tumour like lesions characterized by proliferation of trophoblastic tissue. Amongst GTD, hydatidiform moles are the most common form. These lesions sometimes may develop into invasive moles, or, in rare cases, into choriocarcinoma. Risk factors of GTD include extreme of reproductive age, multiparity, smoking, alcohol consumption, lower socioeconomic class etc. Materials and Methods: The present study was descriptive, observational, analytical type done in Department of Pathology at M.P. Shah Medical College Jamnagar. All cases clinically suspected of GTD were included and its correlation with serum beta hCG was studied. The cases of GTD were classified according to WHO classification. Estimation of serum beta hCG level was done by using Indirect Sandwich Enzyme Linked Immunosorbent Assay (ELISA). Results: During study period of 1 year from October 2019 to September 2020, 150 sample received out of which 16 cases were diagnosed as GTD. Most of the cases were of hydatidiform moles, few cases of choriocarcinoma and Placental Site Trophoblastic Tumour (PSTT). The common clinical presentation was per vaginal bleeding and amenorrhea. In majority of cases beta hCG levels were between 50,000 to 100000 mIU/ml. The correlation between beta hCG level and GTD was done. Conclusion: Pregnant females clinically presenting with abnormal vaginal bleeding must be evaluated for GTD. Histopathological examination and serum beta hCG level are helpful for confirmatory diagnosis. Follow up beta hCG level is very useful indicator to detect these lesions and its recurrences.