Clinical profile and outcomes of gestational trophoblastic disease: A prospective observational study from a tertiary care center, India
Hena Kausar, Shashi Bala Singh, Kiran TrivediBACKGROUND:
Gestational trophoblastic disease (GTD) is a group of uncommon pregnancy-related placental disorders, ranging from benign conditions such as hydatidiform mole (partial and complete mole), malignant gestational trophoblastic neoplasia (GTN), including invasive mole and choriocarcinoma. Differentiation from normal pregnancy remains a concern; however, an early diagnosis and appropriate treatment may allow good outcomes.
OBJECTIVES:
The objective of this study was to determine the clinical characteristics and outcomes of patients developing GTDs.
METHODS:
A prospective observational study was conducted from March 2019 to August 2020 on 58 women with GTD. Data were collected from hospital registries about the clinical details and outcomes. Suction evacuation was the primary management, with chemotherapy for GTN. Patients were monitored with serial beta-human chorionic gonadotropin levels until normalization. Clinical details of benign (partial and complete mole) versus malignant (GTN) were compared. Mortality was recorded as primary outcome.
RESULTS:
The mean age was 28.74 ± 7.98 years. Mean gestational age at diagnosis was 11.89 ± 4.1 weeks. Bleeding per vagina (91.4%) and amenorrhea (79.3%) were the most common presentations. Histopathological examination revealed partial mole in 27 (46.55%) cases, complete mole in 23 (39.66%) cases, invasive mole in 3 (5.17%) cases, and choriocarcinoma in 5 (8.62%) patients. One death occurred in a high-risk choriocarcinoma case due to excessive uterine bleeding.
CONCLUSION:
GTDs in our cohort predominantly presented during the first trimester with vaginal bleeding, with partial hydatidiform mole being the most frequent diagnosis. Molar pregnancy was successfully managed with suction evacuation; whereas GTN was managed with chemotherapy, with one mortality.