Gestational Trophoblastic Disease: A Hospital-Based Prospective Study to Characterize Incidence, Risk Factors, Management and Review of Literature

Abstract

This study was conducted to prospectively evaluate the incidence of gestational trophoblastic disease (GTD) and characterize the host factors, risk factors, histology, management and follow-up in a tertiary care hospital in Mysore, India. All patients diagnosed with hydatidiform mole in the hospital during July 2011 to December 2012 were enrolled and followed up for 6 months from the date of surgical evacuation. A systematic review of literature related to epidemiology of GTD published between 2000 and 2019 was performed. A total of 52 women were diagnosed to have GTD with 20,385 live births reported in the same duration. The mean age at presentation was 21.56 ± 2.9 years (range 18–30). Mean gestational age at presentation was 12.40 ± 4.1 weeks. Histopathology revealed 53.8% partial hydatidiform mole, 44.2% complete hydatidiform mole, and 1.9% invasive mole. The median duration to reach normal beta-hCG levels was 8 weeks (range 6–12 weeks). Suction evacuation was the primary mode of treatment. Three (5.8%) patients were diagnosed with gestational trophoblastic neoplasia. The incidence of GTD in the study was 2.6 per 1000 live births. There is a large variation in the incidence rates reported from India, and they are generally higher than the rates reported from Europe and the USA and consistent with other Asian studies. The host factors and the follow-up requirements characterized in the study will help design future population-based studies.