A Five-Year Retrospective Study of Gestational Trophoblastic Disease at University of Maiduguri Teaching Hospital Maiduguri, Nigeria

Abstract

Background: Gestational trophoblastic disease (GTD) is an uncommon complication of pregnancy. It is of clinical and epidemiological interest partly because of its good prognosis if detected and managed early. Objective: This study was to determine the prevalence, clinical presentation, management outcome and histologic types of GTDs at University of Maiduguri Teaching Hospital, Maiduguri, Nigeria. Methodology: A five-year retrospective study of histologically confirmed cases of GTDs managed in UMTH was undertaken. Folders of patient treated for GTD during the study period served as source of data. Statistical analysis was done using Statistical Package for the Social Sciences. Results: There were a total of 47 (38 molar and 9 choriocarcinoma) cases of GTDs that were diagnosed and managed at UMTH. However, only 40[31(77.5%)] molar and [9(22.5%) choriocarcinoma] case files were retrieved. 55% of the GTDs were complete hydatidiform mole, 22.5% partial hydatidiform mole and 22.5% choriocarcinoma. There was no case of invasive mole or placental site trophoblastic tumour noted. There were 15,426 deliveries in UMTH during this period giving the incidence of GTDs as 3.0 per 1000 deliveries or 1 in 328deliveries. The mean (SD) age of the patients was 30.5 ± 5.6years. Only 3(7.5%) of the patients were below 20 years of age and those who were at least 40 years of age constituted 8(20%). Low parity constituted 62.5% of the patients while 12.5% and 2.5% were nullipara and primipara respectively. The mean gestational age (SD) at presentation was 16.5±6.2 weeks. The common clinical presentations were amenorrhoea (100.0%), abnormal vaginal bleeding (97.5%), lower abdominal pain (90%) and passage of grape-like vesicles (45.0%). Only 6(15.0%) complied with the follow-up protocol for one year, while 25(62.5%) of the patients did not observe the follow-up protocol. Anaemia was the commonest complication observed. Conclusion: Gestational trophoblastic disease is relatively common in our center with an incidence of 3.0 per 1000 deliveries and 1.48% of our gynaecological admissions. Adequate patient counseling and compliance to follow-up are recommend for good outcome. Keywords: Prevalence, gestational trophoblastic disease, Hydatidiform mole, Choriocarcinoma, Maiduguri.