Gestational Trophoblastic Disease and Gestational Trophoblastic Neoplasm - An Experience at Tertiary Care Hospital

Abstract

Objective: To determine the frequency of gestational trophoblastic diseases and gestational tropho- blastic neoplasm, its risk factors and prognosis.
 Methods: This was a descriptive, cross-sectional study conducted at Civil Hospital, Karachi from March 2015 to September 2015. All cases of gestational trophoblastic disease after necessary inves- tigations like tumour marker b-hCG, ultrasound with classical picture of "bunch of grapes" or "snow storm" pattern and X-ray chest (for lung metastases) under went suction evacuation. In all cases specimen was sent for histopathology to confirm gestational trophoblastic disease. After primary treat- ment, cases were followed with b-hCG till complete remission was achieved. During follow-up, cases were labelled as gestational trophoblastic neoplasm on the basis of International Federation of Gyne- cology and Obstetrics (FIGO) criteria. After risk scoring on World Health Organization (WHO) criteria, chemotherapy was given.
 Results: Out of 497 pregnant ladies, 40 were cases of gestational trophoblastic disease (8.05%). Frequency/obstetric case was 1.7% and frequency/delivery was 2.1%. Out of 40 cases 13 (32.5%) were cases of gestational trophoblastic neoplasm. Out of 13 cases of gestational trophoblastic neo- plasm 9 (69.23%) were labelled as low-risk and 4 (30.76%) as high-risk cases. All cases achieved complete remission. One case of high-risk group expired.
 Conclusion: All women with gestational trophoblastic disease must be followed as per recommenda- tion with serum b human chorionic gonadotropin measurement until the levels are undetectable, for early diagnosis and optimum treatment of gestational trophoblastic neoplasm.