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

Abstract

Objective We sought to determine the prevalence of and factors associated with hydatidiform molar gestations amongst patients undergoing uterine evacuation at Mbarara Regional Referral Hospital (MRRH), Mbarara, Uganda. Methods This was a cross-sectional study carried out from November 2016 to February 2017. All patients admitted for uterine evacuation for nonviable pregnancy were included. The study registered 181 patients. Data were collected on sociodemographics, medical conditions, obstetrics, and gynecological factors. The evacuated tissue received a full gross and histopathologic examination. Cases of pathologically suspected complete hydatidiform mole were confirmed by p57 immunohistochemistry. Data were analyzed using STATA 13. Results The prevalence of hydatidiform mole was 6.1% (11/181). All detected moles were complete hydatidiform moles, and there were no diagnosed partial hydatidiform moles. Clinical diagnosis of molar pregnancy was suspected in 13 patients, but only 69.2% (9/13) were confirmed as molar pregnancies histologically. Two cases were clinically unsuspected. Factors that had a significant relationship with complete hydatidiform mole included maternal age of 35 years and above (aOR 13.5; CI: 1.46–125.31; p=0.00), gestational age beyond the first trimester at the time of uterine evacuation (aOR 6.2; CI: 1.07–36.14; p=0.04), and history of previous abortion (aOR 4.3; CI: 1.00–18.57; p=0.05). Conclusion The prevalence of complete hydatidiform mole was high at 6.1%. Associated risk factors included advanced maternal age (35 years and above), history of previous abortions, and gestational age beyond the first trimester at the time of evacuations. Recommendations We recommend putting in place capacity to do routine histopathological examination of all products of conception especially those at high risk for a molar gestation either by clinical suspicion or by risk factors including advanced maternal age, advanced gestational age, and history of previous abortion because of high prevalence of complete mole.

Genital Chlamydia trachomatis Infection among Women of Reproductive Age Attending the Gynecology Clinic of Hawassa University Referral Hospital, Southern Ethiopia

“…Itis possible that the prevalence of CT infection reported in our study represents a true picture of the disease since the reported condom usage was very low, which may suggest further investigation of other risk behaviors like non-monogamous spouses [15]. In contrast to our finding, higher rates of CT infection were reported in women attending gynecology clinics in Mbarara, Uganda (26.5%) [16], Jos, Nigeria (51.6%) [17]and South Eastern Nigeria(40.7%) [18]. However, lower rates of CT was reported in Western Kenya (3%) [19], North Western Nigeria(9.6%) [15]and Iran (8.3%) [20].…”

“…Similar findings have been reported in other studies [12, 22]. In contrast with previous literature, marital status [15] and other factors that might be associated with CT, including urban residence [16], multiple sexual partners [8], and pre-marital sex were not found to be significant risk factors in this study. In Ethiopia, it was difficult to obtain information regarding sexual behavior because of socio-cultural inhibitions.…”

“…However, lower rates of CT was reported in Western Kenya (3%) [19], North Western Nigeria(9.6%) [15]and Iran (8.3%) [20]. These disparities in prevalence rates could be due to a varying distribution of risk factors in different populationand geographical regions as well as different laboratory methods, which may have different sensitivity and specificity [16, 17]. …”

Histopathological examination of products of conception after first-trimester miscarriage

“…A study, by Oliver M et al, found that 13 patients with ultrasound scan diagnosis of molar pregnancy who underwent suction curettage, only 9 (69.2%) were confirmed to be complete moles [10].…”

Correlates of genital Chlamydial trachomatis infection in a cohort of infertile women in Ibadan, Nigeria

“…2,5 A study in Ibadan found the prevalence of Chlamydia cervicitis to be 17.6% among women undergoing hysterosalphingography for infertility evaluation while several studies have proven that C. trachomatis infections rates are higher among infertile than fertile women. 3,[5][6][7][8][9][10][11][12][13][14][15] Patients with positive Chlamydia assay are 1.7 times at risk of infertility compared with patients with negative assay. 5 A study reported that Chlamydia trachomatis IgG was significantly higher among patients presenting with infertility than those that did not.…”