Host and risk factors for gestational trophoblastic disease: a hospital-based analysis from India.

Abstract

BACKGROUND:

Gestational trophoblastic disease (GTD) adversely affects pregnancy by the development of Hydatidiform mole and placental site gestational tumor. GTD is a discrete pool of epidemiological and clinicopathological entities. Therefore, every geographical region should be studied separately. The Indian subcontinent is under-reported for this disease. This paper analyses the data from a large hospital.

MATERIAL/METHODS:

92 patients with GTD were analyzed in the period from 1995 to 1999.

RESULTS:

The incidence of GTD was 1.31 per 1000 live births and one per 967 pregnancies irrespective of outcome. 93.5% of the patients had moderate to severe vaginal bleeding as presenting symptom, while routine antenatal ultrasonography revealed GTD in 6.5% completely asymptomatic patients. Among the major risk factors were age over 30 (p=6.3 x 10(-3), RR=2.7), previous abortion (p<0.001, RR=3.9) and multigravida (p=4.9 x 10(-6), RR=4.1). Early detection and treatment on established lines can achieve 95.7% complete response and 6.5% partial response. 17 out of 21 invasive moles (80.9%) were found with multiple abortions and mechanical interference in form of check curettage, which probably implicates repeated mechanical interference in the conversion of a mole into an invasive one.

CONCLUSIONS:

The present study explores the status of established host-related risk and prognostic factors in the Indian context. In cases of invasive mole, the role of repeated mechanical interference in the form of check curettage needs further evaluation.

• Authors: Neeta Kumar, Yogesh Kumar Saxena, Arun Kumar Rathi, Raghunandan Chitra, Pratik Kumar
• Journal: Medical science monitor : international medical journal of experimental and clinical research (Med Sci Monit) Vol. 9 Issue 10 Pg. CR442-7 (Oct 2003) ISSN: 1234-1010 [Print] United States
• PMID: 14523334 (Publication Type: Journal Article)

Chemical References

• Chorionic Gonadotropin

Topics

• Adolescent
• Adult
• Age Factors
• Chorionic Gonadotropin (metabolism)
• Female
• Gestational Trophoblastic Disease (diagnosis, pathology)
• Hospitals
• Humans
• Hydatidiform Mole (diagnosis, pathology)
• India
• Pregnancy
• Risk
• Risk Factors
• Ultrasonography