Hydatidiform mole: A review of management outcomes in a tertiary hospital in south-east Nigeria

Abstract

Background:Hydatidiform mole (molar pregnancy) is the pre-malignant form of gestational trophoblastic neoplasia. It is of clinical and epidemiological interest because of its significant complication in pregnancy.Aim:This study was to determine the incidence, risk factors, clinical presentations, diagnosis, treatment options, and outcomes of molar pregnancy in a Nigerian tertiary health institution.Materials and Methods:A 10-year retrospective study of patients with molar pregnancy managed at the hospital from 1st July 2001 to 30th June 2010 was undertaken.Results:There were 34 cases of molar pregnancy, out of a total delivery of 7,579, giving an incidence of 0.4% or 1 in 223 deliveries. The mean age of the patients was 31.3 (8.7) years, and 29.0% (9/31) of the patients were nulliparous. The mean gestational age of the patients at presentation was 14.7 (3.5) weeks. The most common presenting symptom was abnormal vaginal bleeding, 93.5% (29/31), while anemia was the commonest complication seen in 96.8% (30/31) of patients. Almost all the patients (93.5%) had suction evacuation while 6.5% (2/31) had hysterectomy. As many as 6.5% (2/31) of patients had post-evacuation chemotherapy while 87.1% (27/31) patients had follow-up contraception. As many as 64.5% (20/31) of patients had complete follow-up for less than 6 months. The case fatality rate was 9.7%.Conclusion:Molar pregnancy has remained an important cause of maternal morbidity and mortality in our hospital, and the incidence was high. There is need for early recognition, timely referral, prompt and proper treatment of this condition. Adequate follow-up of the patients should be reinforced.

Gestational Trophoblastic Diseases: A Review of the Clinical Presentation and Management at the Alex Ekwueme Federal University Teaching Hospital Abakaliki

“…However, in this study, only 3% of patients had a prior history of GTD. This is similar to a study in Jos in which 8% of patients had a previous history of GTD [8].…”

“…years. The findings from this study do not support this; it is however in conformity with studies done in Jos and Nnewi [7] [8]. Women less than 20 years and those more than 40 years of age accounted for 29.4%.…”

“…Gestational trophoblastic diseases are usually suspected in patients with amenorrhoea presenting with vaginal bleeding, the passage of grape-like vesicles, hyperemesis gravidarium, fundal height greater than estimated gestational age and positive serial hCG estimation [1]- [8].…”

Prevalence and Factors Associated with Hydatidiform Mole among Patients Undergoing Uterine Evacuation at Mbarara Regional Referral Hospital

“…The incidence is higher in women younger than 20 years and older than 40 years of age. It is also higher in nulliparous women, in patients of low economic status, and in women whose diets are deficient in protein, folic acid, and carotene [4]. …”

Complete Hydatiform Mole Revealed by a Severe Preeclampsia on Added in a 39-Year-Old Pregnant: Report of a Case Followed in Kisangani (DRC) and Review of the Literature

“…Aghajanian P. [19] think that preeclampsia in the first trimester or early second trimester is an exceptional finding in a normal but pathognomonic pregnancy of one hydatiform mole.…”