A five - year review of gestational trophoblastic diseases in Port Harcourt, Nigeria

Abstract

Background: Gestational Trophoblastic Diseases (GTD) are a spectrum of inter-related but histologically distinct tumours originating from the placenta with good prognosis when diagnosed early.

Aim: To determine the prevalence, clinical presentations, management of gestational trophoblastic disease at the University of Port Harcourt Teaching Hospital, Port Harcourt, Nigeria.

Methods: A retrospective analysis of women treated for gestational trophoblastic disease from 1^st January 2008 to 31^st December 2012. The information from patients records: age, occupation, educational level, husband's occupation, parity, presenting symptoms, uterine size, mode of treatment and management options were collated and analysed. The Chi-square test was used to compare categorical variables with a p value of ≤ 0.05 as significant.

Results: A total of 38 cases of GTD were treated with a prevalence of 2.3 per 1,000 deliveries. The mean age and parity were 31 ± 6.3 years and 2 ± 1.6 respectively. Maternal age less than 35 years and low socioeconomic status were significantly associated with GTD  (p=0.0000). The mean gestational age at presentation was 16.24 ± 5.4 weeks. The commonest clinical presentation was amenorrhoea in 100% of patients. Twenty-five(65.8%) cases of hydatidiform mole and 13(34.2%) cases of choriocarcinoma were observed. Twenty-two (57.9%) patients had suction evacuation only for hydatidiform mole, 3(7.9.%) had suction evacuation and cytotoxic therapy for hydatidiform mole and subsequent persistent trophoblastic disease while 8(21.1%) had chemotherapy for choriocarcinoma. Five patients with advanced choriocarcinoma did not receive definitive treatment before demise. Twenty (52.6%)defaulted in their follow up schedule.

Conclusion: There is high prevalence of GTD in Port Harcourt with high mortality among patients with malignancy. Most of the patients defaulted in their follow up; thus there is a need for education and sensitization of the populace on GTD, as well as proper counseling of patients treated on the benefits of follow up visits

Keywords: Gestational trophoblastic disease, Prevalence, Management, Outcome, Port Harcourt