Abstract
Objective: To describe the place of ultrasound in the diagnosis and management of Gestational Trophoblastic Diseases (GTD) at the Ouagadougou UTH-YO, Ouagadougou, Burkina Faso. Materials and Patients: It was a prospective and descriptive study over a 3-year period from 1 January 2015 to 31 December 2017. It took place in the gynecology and obstetrics department of at the University Teaching Hospital Yalgado Ouedraogo (UTH-YO) of Ouagadougou. Monitoring was based on clinical examination data, ultrasound and kinetics of β-gestational chorionic hormone (GCH) levels. Results: During the study period, we recorded 34 cases of trophoblastic diseases. The average age of the patients was 35 years with extremes of 22 and 52 years. Physical examination revealed a uterus larger than gestational age in 17 patients (56.67%) of cases. Eight (26.67%) patients were asymptomatic. The initial mean β-GCH was 453,747.8 IU/l with extremes of 5903 IU/l and 1,890,000 IU/l. Ultrasound was used to evoke the diagnosis in 23 patients, that to say 76.67% of the cases. Ultrasound identified 10 complete mole cases, 20 partial mole cases. For the 3 cases of invasive mole, pelvic ultrasound revealed heterogeneous intrauterine multi-vesicular images. In a case of choriocarcinoma, ultrasound found an enlarged uterus with a poorly limited intracavitary heterogeneous fundic image. Conclusion: This short series shows the central role of ultrasound in the diagnosis and follow-up of gestational trophoblastic diseases. Indeed, the sensitivity of ultrasound is excellent in the early diagnosis of complete moles. Ultrasonography remains a good examination choice for the diagnosis of gestational trophoblastic tumors despite their great polymorphism. The place of ultrasound in prognostic evaluation and treatment monitoring deserves to be studied by more important series.
Highlights
Gestational trophoblastic diseases (GTD) constitute a real public health problem for African countries because of their high incidence, their evolutionary potential and the difficulties related to their diagnosis and management [1]
Monitoring was based on clinical examination data, ultrasound and kinetics of β-gestational chorionic hormone (GCH) levels
In a case of choriocarcinoma, ultrasound found an enlarged uterus with a poorly limited intracavitary heterogeneous fundic image. This short series shows the central role of ultrasound in the diagnosis and follow-up of gestational trophoblastic diseases
Summary
Gestational trophoblastic diseases (GTD) constitute a real public health problem for African countries because of their high incidence, their evolutionary potential and the difficulties related to their diagnosis and management [1]. The incidence varies from country to country and sometimes exceeds 1 in 500 pregnancies [2]. In Burkina Faso, a national study in 1998 estimated it at 9.7 per 1000 pregnancies [1]. Diagnostic and management modalities were formerly based on clinical history and biological data. They largely include imaging including ultrasound and magnetic resonance imaging (MRI). We propose to describe the place of ultrasound in the diagnosis and management of GTD at the Ouagadougou UTH-YO with a view to sharing experiences
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