: Gestational tropoblastic disease (GTD) comprises of heterogeneous group of pregnancy related disorders which occurs due to highly abnormal development and proliferation of tropoblastic tissue. The spectrum encompasses benign conditions like partial and complete hydatidiform mole, malignant condition like invasive mole, choriocarcinoma, placental-site trophoblastic tumor, and epithelioid trophoblastic tumor. The most common disease among the above is the complete mole. There is wide variation in the incidence and risk factors of occurrence of GTD in different geographic regions. In present study, we evaluate incidence, clinical profile and management of GTD at a tertiary care centre.
Material and Methods: The present study is prospective observational study done in department of obstetrics and gynecology at a tertiary care centre for duration of 2 years. All the cases diagnosed as gestational tropoblastic disease were included in study. The incidence, clinical presentation, management and six months follow up data were analyzed.
Observation and Results: There were 12,046 pregnancies, 11952 deliveries and 11620 live births during the present study. The total number of cases diagnosed to have GTD was 30, and they were included in study. This gave an incidence of 2.49 /1000 pregnancies, 2.51 /1000 deliveries and 2.58 /1000 live births. The most common presenting symptom was blood per vagina, noted in 21(70%) patients. Other symptoms were pain abdomen 11(37%), vomiting 4(13%). Only 2(7%) had classic symptom of passage of grape like vesicles. Histopathology examination showed 23 patients had complete hydatidiform mole, 6 had partial hydatidiform mole and one had invasive mole.
Conclusion: The incidence of hydatidiform mole and other forms of GTD were comparable to other reported studies in literature. Those pregnant patients, who are clinically or sonologically diagnosed as GTD should be evaluated properly and managed accordingly. These patients need proper follow up care to prevent complications and further, preserve fertility in them.