Trend of Complete Hydatidiform Mole

Thapa, Kusum; Shrestha, Madhu; Sharma, Sudha; Pandey, S.

doi:10.31729/jnma.123

Cited by 7 publications

(6 citation statements)

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“…11 But Thapa's study found higher incidence of mole among primigravidae (36.7%) and Elpo in Nigeria reported that parity four and above in particular adds to the risk. 11,12 In present study we found that the incidence of GTD was 39% in primi and 51.8% in gravida one to four.…”

Section: Resultssupporting

confidence: 50%

Patient profile of gestational trophoblastic disease at Patan Hospital, Nepal

Singh

Shrestha

2015

J Patan Acad Health Sci

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Introductions: This study was designed to determine the demographic pattern, incidence, clinical features and management outcome of gestational trophoblastic disease (GTD) in Patan Hospital.Methods: This was a cross sectional study conducted at Patan Hospital from April 13, 2008 to April 12, 2013. Medical record of cases diagnosed as GTD were retrieved from the record section for review. The age, parity, estimated gestational age at the time of evacuation, presence or absence of vaginal bleeding, uterine size in relation to gestational age, ultrasonogram report and urinary beta human chorionic gonadotropin level, histopathology findings, modalities of treatment and outcomes were analyzed.Results: There was total of 41,543 deliveries during five years study period and 54 GTD on histopathology. Among the 54 GTDs, 40 (74%) were molar pregnancy, 8 (14.4%) invasive mole and 6 (11%) choriocarcinoma. The frequency of GTD was 1 per 769 pregnancies. The age of the women with GTD ranged from 15-50 years. Half of the cases were below 25 years. Most of the women presented between 8-12 weeks of gestation and below third gravida. Amenorrhea with vaginal bleeding was seen in 49 (90%) patients.Conclusions: The most common GTD observed in this study was molar pregnancy. Vaginal bleeding was the common complaints at presentation.Journal of Patan Academy of Health Sciences, Vol. 2, No. 1, 2015. page: 3-6

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Section: Resultssupporting

confidence: 50%

Patient profile of gestational trophoblastic disease at Patan Hospital, Nepal

Singh

Shrestha

2015

J Patan Acad Health Sci

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“…The most common clinical manifestation was abnormal vaginal bleeding, a few accompanied with abdominal pain, nausea or vomiting, which is consistent with the clinical manifestations of young patients. Interestingly, 8.6% of patients in our study presented with amenorrhea as the only symptom, compared to just 0.8% in young patients [ 34 ], hinting a major difference in presentation. This phenomenon should alert physicians during clinical practice.…”

Section: Discussionmentioning

confidence: 69%

Comparison of different therapeutic strategies for complete hydatidiform mole in women at least 40 years old: a retrospective cohort study

2017

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BackgroundThere are three main therapeutic strategies, namely expectant management (dilation and curettage only), prophylactic chemotherapy and prophylactic total hysterectomy for treating older women with complete hydatidiform mole (CHM). However, the scientific community has so far, not unanimously accepted the above-mentioned methods. The objective of this study was to evaluate the effectiveness of these therapeutic strategies in preventing post-molar gestational trophoblastic neoplasia (GTN) pertaining to patients with CHM who were at least 40 years old.MethodsHundred and seventy-one patients from our hospital who had histologically been diagnosed of CHM and underwent treatment from January 2004 to December 2013 were included. All patients were followed continuously for a minimum of 2 years after which relevant clinical data were extracted and analysed.ResultsAll patients were divided to three groups. Group 1 consisted of 124 patients, treated by expectant management, and the incidence of post-molar GTN was 37.1%. Group 2 included 12 patients who received prophylactic chemotherapy, with an incidence of 41.7%. The remaining 35 patients, Group 3, underwent prophylactic total hysterectomy, with the lowest incidence of 11.4%. A significantly lower incidence was noted in group 3 as compared to group 1 (P = 0.004). GTN patients who received prophylactic chemotherapy required, on average, longer time to be diagnosed of GTN and had higher probability of chemotherapy resistance (P = 0.031 and P = 0.024).ConclusionsThis retrospective analysis showed that prophylactic total hysterectomy was the most effective therapeutic strategy for treating CHM in women at least 40 years old of age.Electronic supplementary materialThe online version of this article (10.1186/s12885-017-3749-8) contains supplementary material, which is available to authorized users.

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“…While in the current study, more than one third of the patients were in the age group of 20–35 years with a range of 16–51 and mean age of 23.7 years. Prevalence of molar pregnancy was found to be higher in women younger than 29 years (80 %) in another 8 year retrospective study done in Kathmanudu [ 9 ]. In other studies, it has been found that there is a relationship between risk of molar pregnancy and both upper and lower extremes of maternal age.…”

Section: Discussionmentioning

confidence: 99%

“…The incidence of GTD varies greatly in different parts of the world, with 0.4 per 1000 birth in United States of America to 12.5 per 1000 births in Taiwan [ 8 ]. In Nepal, hospitals in Kathmandu valley have recorded its incidence as 5.1, 2.9, 2.8, and 4.1 per 1000 live births [ 9 ]. These 10–20‐fold variations in the incidence of molar pregnancy might be overestimated by reporting biases, such as population‐based and hospital‐based data [ 2 ].…”

Section: Introductionmentioning

confidence: 99%

Clinico-epidemiological profile of molar pregnancies in a tertiary care centre of Eastern Nepal: a retrospective review of medical records

Agrawal

Sagtani

Budhathoki

et al. 2015

gynaecol oncol res pract

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BackgroundThe incidence of molar pregnancy has demonstrated marked geographic and ethnic differences. The reported data in Nepal is inconsistent with minimal published literature. Thus, we designed a study to determine prevalence of molar pregnancies and demonstrate clinical and epidemiological characteristics of the patients attending a tertiary care center in eastern Nepal.MethodsA retrospective review of medical records was conducted to determine the prevalence of molar pregnancies at the B.P. Koirala Institute of Health Sciences (BPKIHS) from the year 2008 to 2012. Secondary data from the medical records were analyzed. Annual and 5-year prevalence of molar pregnancy per 1000 live births was calculated. Demographic characteristics, clinical presentation, management methods and complications of molar pregnancy were studied.ResultsThe 5- year prevalence of molar pregnancy at BPKIHS is 4.17 per 1000 live births with annual prevalence ranging 3.8–4.5 per 1000 live births. More than one third of the patients were in the age group of 20–35 years and majority of them were of Hindu religion. For more than one third (41.7 %) of the patients, it was their first pregnancy while about 10 % gave a positive past history of molar pregnancy. Abnormal uterine bleeding (86.3 %) was the most frequent complaint, suction evacuation was the most common method of treatment and more than half of the patients required prolonged care after initial management.ConclusionThere is a need for studies at country level which will give us a national figure on molar pregnancies. Thus, a standardized clinic-epidemiological profile of molar pregnancy in Nepal can be created.

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Trend of Complete Hydatidiform Mole

Cited by 7 publications

References 1 publication

Patient profile of gestational trophoblastic disease at Patan Hospital, Nepal

Patient profile of gestational trophoblastic disease at Patan Hospital, Nepal

Comparison of different therapeutic strategies for complete hydatidiform mole in women at least 40 years old: a retrospective cohort study

Clinico-epidemiological profile of molar pregnancies in a tertiary care centre of Eastern Nepal: a retrospective review of medical records

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