Gestational Trophoblastic Disease in Malta

Abstract

Background: Gestational trophoblastic disease (GTD) is a group of uncommon conditions associated with pregnancy and includes a spectrum of premalignant to malignant disorders. The aim of this study is to determine the local incidence of GTD and to analyses the management that is being offered to patients with GTD in Mater Dei Hospital. Methodology: All patients diagnosed with GTD from 1st January 2015 till 31st December 2020 were studied. The list of patients with GTD was obtained from the Pathology Department and data was collected from medical records, iSOFT and electronic discharge summaries. Results: In this 6-year study period, 83 cases of GTD were identified. 79.5% of patients had partial hydatidiform mole and 16.9% had complete mole. 3.6% were cases of gestational trophoblastic neoplasia. 55.4% of patients received medical treatment with vaginal misoprostol and 27.7% had immediately surgical management. Their follow-up was studied; 21.7% had 3 out-patients visits or less, 33.7% had between 4 to 6 visits and 19.3% had 7 to 15 outpatients visits. 7.2% had extra oncology out-patients visits. 40% of patients had a follow-up that lasted for 7 months or more. Conclusion: GTD in Mater Dei Hospital appears to be an uncommon disease, but the local incidence was noted to be as high as 1 per 319 living births. This study demonstrated that a large number of patients were medically treated and the follow-up received was noted to be inconsistent. The care of these patients can be highly optimized by the set-up of a small dedicated clinic