Incidence, Management, and Outcome of Molar Pregnancies at a Tertiary Care Hospital in Quetta, Pakistan

Fatima, Mahrukh; Kasi, Pashtoon Murtaza; Baloch, Shahnaz Naseer; Kassi, Masoom; Marri, Shah Muhammad; Kassi, Mahwash

doi:10.5402/2011/925316

Cited by 18 publications

(32 citation statements)

References 8 publications

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“…5 However, Fatima et al, noted bleeding per vaginum to be the commonest symptom seen in as many as 94.2%. 14 One of the most classical symptom i.e. passage of grape like vesicles per vaginum was seen in only 9.1% of patients in the present study; while in the Nigerian study by Ocheke AN et al, it was found in 60% cases.…”

Section: Discussioncontrasting

confidence: 64%

“…Age less than 20 years is not considered as a risk factor by WHO, though some experts have observed both extremes (<20 years and >35 years) to be at increased risk of disease. [12][13][14][15] In the present study the commonest symptom after amenorrhea is per vaginum bleeding, seen in 68.2% of patients. The clinical study from Dubai reported incidence of vaginal bleeding in 29% patients only.…”

Section: Discussionsupporting

confidence: 52%

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Clinical study of gestational trophoblastic disease in a tertiary care hospital

Mulik

Choudhary

2020

Int J Reprod Contracept Obstet Gynecol

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Background: Gestational trophoblastic diseases (GTDs) had been associated with significant morbidity and mortality till recently. Wide variation in incidences have been reported worldwide. The present study was planned with the objective of determination of incidence, assessment of risk factors, clinical presentation, management protocols and outcomes in GTD cases in Indian population at a tertiary care centre.Methods: All the diagnosed cases of GTD reporting to study centre during study period of 1.5 years were included. Detailed history taking, examination and relevant investigations (Hb%, blood grouping, thyroid functions, serum ß-hCG, USG and chest X-ray) were undertaken. Suction and evacuation were done for all patients as primary mode of management and samples were sent for histopathological examination. Comprehensive follow ups were done, including weekly ß-hCG until normal for 3 consecutive weeks followed by monthly determination until the levels were normal for 6 consecutive months.Results: Total 22 cases out of 19500 deliveries were diagnosed as GTD (incidence rate-1.13/1000 deliveries). Mean age was 23.64±3.89 years with 50% participants being primigravida. The commonest symptom after amenorrhea 22 (100%) was bleeding per-vaginum 15 (68.2%). Maximum cases were of complete hydatidiform mole histopathology 16 (72.73%), USG 19 (86.4%). Clinical characteristics were statistically comparable between patients of complete mole and partial mole. Out of 22 cases, 1 (4.5%) was diagnosed as GTN.Conclusions: Early diagnosis and treatment along with regular follow up is the key in GTD. There is need to establish a centralized disease specific registry in future.

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Section: Discussioncontrasting

confidence: 64%

Section: Discussionsupporting

confidence: 52%

Clinical study of gestational trophoblastic disease in a tertiary care hospital

Mulik

Choudhary

2020

Int J Reprod Contracept Obstet Gynecol

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“…Mean age of GTD cases was 25.09±7.9 years (Range:15-50 years). Among 102 cases of GTD, range of parity was from 0 to 11 which was comparable (0 to 17) to a study by Fatima et al 10 In this study, most of the GTD cases presented as P/V bleeding (67.6%) which is similar to studies conducted by Fatima et al 10 and Hou et al 11 USG diagnosed cases of GTN in 29.4% and more than half of these,17/30 (56.6%) were diagnosed in first trimester, reflecting the diagnosis of disease by USG in early pregnancy. 12 The risk of GTN for complete HM (15-20%) is significantly higher than for partial HM (0.2-4%) [13][14][15][16] as was also noted in this study CHM (15.5%) and PHM (5.5%).…”

Section: Discussionsupporting

confidence: 55%

Trends of Gestational Trophoblastic Disease at a Tertiary Care Hospital

Shakya¹,

Baral

2018

Nepal j. obstet. gynaecol.

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Aims:The objective of this study was to determine the clinical presentation of GTD and response of GTN to single and multiple agent chemotherapy on the basis of WHO Prognostic risk scoring system. Methods:This was a cross-sectional retrospective study undertaken at Paropakar Maternity and Women's Hospital. The medical records of 102 GTD cases were reviewed from January 25, 2015 to January 24, 2016. Data pertaining patient characteristics, histopathology types of GTD, management, prognostic risk scores, chemotherapy, follow up and remissions were retrieved and were analyzed using SPSS version 16.0.Results: Among 102 GTD cases, the most common presentation was vaginal bleeding 69(67.6%) followed by ultrasound diagnosed cases 30(29.4%). Primary management of all cases were suction evacuation, 68 completed and 12 are under follow-up. GTN was diagnosed in 14/90 (15.5%) of complete mole and 5/90 (5.5%) of partial mole. Twenty-two cases received chemotherapy for persistent gestational trophoblastic tumour(19) and invasive mole(3). Twenty cases were low risk score group and two cases under high risk group. Out of 20 low risk cases that received MTX-FA, 13/20 (65%) achieved remission. Due to low response of MTX-FA, five of them were converted to Actinomycin-D and achieved remission(100%). Two high risk cases received EMA-CO regimen and achieved 100% remission. Two low risk GTN, complete and invasive mole (underwent hysterectomy) are undergoing MTX-FA chemotherapy. Conclusions:The most common presentation of GTD was vaginal bleeding. Low risk GTN achieved 65% remission with Methotrexate-Folinic acid, ultimately achieved 100% remission with Actinomycin-D. High risk GTN achieved 100% remission with EMA-CO regimen.

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“…Asian women are at higher risk of developing hydatidiform mole. The incidence of hydatidiform mole in Southeast Asia is approximate 0.5 % [ 12 ], which is significantly higher than that in the United States and the United Kingdom. Interestingly, Caucasians have higher incidence of hydatidiform mole than African Americans.…”

Section: Discussionmentioning

confidence: 99%

“…Although the incidence of ectopic pregnancy has not changed substantially in the United States since the early 1990s [ 7 , 8 ], other studies showed that the incidence of ectopic pregnancy has increased during the 1980s and 1990s in developed countries including the United Kingdom [ 4 , 9 , 10 ]. The incidence of hydatidiform mole is lower in the United States (1 in 1000 pregnancy), but it is much higher in Asia, up to 1 in 100 pregnancy in Indonesia as well Pakistan [ 11 , 12 ]. One study has also indicated that incidence of hydatidiform mole is increased from 1 in 611 viable conceptions in 1997 to 1 in 528 viable conceptions in 2008 in United Kingdom [ 13 ].…”

Section: Introductionmentioning

confidence: 99%

Trends in ectopic pregnancy, hydatidiform mole and miscarriage in the largest obstetrics and gynaecology hospital in China from 2003 to 2013

Chen

et al. 2016

Reprod Health

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BackgroundEctopic pregnancies, miscarriages and hydatidiform moles are the major types of pathological pregnancies in the early gestations of pregnancy and constitute an important public health problem. The trends and incidences of these pathological pregnancies may vary by ethnicity and geographical regions. This has not been fully investigated in the Chinese population. In this study we retrospectively report the trends of pathological pregnancies in Chinese population.MethodsData on 22,511 women with ectopic pregnancy, hydatidiform mole and miscarriage were collected from the largest obstetrics and gynaecology hospital in China from 2003 to 2013. Data included age at diagnosis and the annual number of women with diagnosed ectopic pregnancy, hydatidiform mole and miscarriage.ResultsThe total number of ectopic pregnancy, hydatidiform mole and miscarriage was increased 3.5folds in 2013 compared to 2003. Ectopic pregnancy is the leading pathological pregnancy and miscarriage is increasing at a greater rate among the pathological pregnancies. The median age of women with hydatidiform mole at diagnosis significantly increased from 25.5 years to 29 years (p = 0.002), however the median age for other pathological pregnancies was not different between 2003 and 2013. The number of women with hydatidiform mole at diagnosis who were over 40 years old has increased. The mean maternal age is increased from 28.1 years old in 2003 to 29.4 years old in 2013 in this hospital.ConclusionWe speculate that the increased maternal age may contribute to the increase in these pathological pregnancies between 2003 and 2013 in China.

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Incidence, Management, and Outcome of Molar Pregnancies at a Tertiary Care Hospital in Quetta, Pakistan

Cited by 18 publications

References 8 publications

Clinical study of gestational trophoblastic disease in a tertiary care hospital

Clinical study of gestational trophoblastic disease in a tertiary care hospital

Trends of Gestational Trophoblastic Disease at a Tertiary Care Hospital

Trends in ectopic pregnancy, hydatidiform mole and miscarriage in the largest obstetrics and gynaecology hospital in China from 2003 to 2013

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