A Prospective Study of Gestational Trophoblastic Disease in Al-Mosul City

Abstract

BACKGROUND: Gestational trophoblastic tumors comprise a wide spectrum of neoplastic disorders that arise fromplacental trophoblastic epithelium after abnormal fertilization which is characterized bytrophoblastic hyperplasia and overgrowth of placental villi. There are several histologically distincttypes of gestational trophoblastic diseases GTD: hydatiform mole (complete or partial),persistant/invasive gestational trophoblastic neoplasia (GTN), choriocarcinoma and placenta sitetrophoblastic tumors. OBJECTIVE: Of the present study is to determine the incidence, clinical presentation and some of its relevantfactors among women admitted to Al-Batool Hospital in Mosul- Iraq. METHODS: The study was conducted in Al-Batool Hospital, Department of Gynecology and Obstetrics, Iraq,Mosul city, from April 2009 to January 2011 as prospective study 9500 patients were analyzedregarding their history, clinical examination, investigations, risk factor. RESULTS: During the analysis, the peak incidence of age is between 21 – 25 years (31.2%). The mostcommon clinical presentation bleeding per vaginal (100%). The peak incidence of the disease iswith para two (36%). Complete hydatidiform mole forming (80%). Partial hydatidiform moleforming (18.4%). Invasive mole forming (1.6%). The mean level of B-hCGin partial mole beforeevacuation is between 3000-4000 mIU/ml. the mean level of B-hCG in complete mole beforeevacuation is between 7000-10000 mIU/ml. CONCLUSION: Frequency of GTD was higher compared to national and international studies. The disease wascommon in young ages, low para and grand multiparous women. Hydatidiform mole was thecommonest type of trophoblastic disease in these patients. Most common presenting complaint wasbleeding per vagina followed by pain in lower abdomen. It appears that the ultrasound ismoderately sensitive in the diagnosis of hydatiform mole pregnancy