A review of gestational trophoblastic diseases in a tertiary hospital

Abstract

Background: Gestational trophoblastic diseases (GTD) result from abnormal proliferation of trophoblastic tissue and although rare, are a recognizable cause of maternal morbidity and mortality worldwide. However, prognosis is good when diagnosed and treated early.

Objectives: To describe the prevalence, pattern of presentation, management practices and outcome of Gestational Trophoblastic Diseases at the University of Abuja Teaching Hospital, Abuja, Nigeria.

Materials and Methods: Case notes of women with a diagnosis of Gestational Trophoblastic Disease from 1st January 2009 and 31st December 2016 were retrospectively reviewed. Relevant information was extracted and entered into structured proformas. The data processing and analysis was done with the aid of SPSS for windows version 20.0. Results were expressed as percentages, means and range.

Results: A total of 51 cases of Gestational Trophoblastic Diseases were reviewed, giving a prevalence rate of 4.4/1000 deliveries. The prevalence of molar pregnancy and choriocarcinoma were 2.4 and 1.6 per thousand deliveries respectively. The age group with the highest frequency of occurrence was the 25-29 years {18(35.3%)} and 25(49%) were para 1-4. The commonest antecedent pregnancy event was a miscarriage in 74.5% of cases while the commonest symptoms were amenorrhoea 46(90.2%) and vaginal bleeding 45(88.2%). These were complicated by anaemia in 18(35.5%) of cases. Thirty (58.8%) women had suction evacuation, 16(31.4%) had chemotherapy and 3(5.9%) had hysterectomy. Loss to follow up was 33(64.7%) and case fatality rate was 19.6%.

Conclusion: Morbidity and mortality resulting from Gestational Trophoblastic Diseases is still high in University of Abuja Teaching Hospital, Abuja. Significant contributing factors were late presentation and poor compliance. Efforts have to be made to reeducate patients and health workers so as to address challenges related to early diagnosis and compliance.

Keywords: Gestational Trophoblastic diseases, Hydatidiform mole, choriocarcinoma, Abuja, Nigeria. Short Title: Gestational trophoblastic diseases in Abuja.