Clinical analysis and management of gestational trophoblastic diseases: a 90 cases study

Abstract

Objective: The aim of the study was to identify the incidence, diagnosis, therapeutic and histological particularities of molar pregnancies and to evaluate our management of gestational trophoblastic tumors (GTT) according to the recommendations of FIGO.

Methods: This was a retrospective study of 90 patients who were diagnosed with molar pregnancy from January 1991 to December 2007. After remission, post molar pregnancy surveillance was continued for one year. Patients whose condition required chemotherapy for GTT were attributed a FIGO/WHO score.

Results: Molar pregnancy occurred in 90 women. The frequency of molar pregnancy was 1 per 1124 pregnancies. The mean age was 32.21 years. Molar pregnancies were more frequent in pauciparous patients (52.24%). At diagnosis, the median gestational age was 13 weeks. The main presenting symptom was metrorrhagia (90%). Treatment consisted in uterine evacuation by suction curettage. Histological findings were complete mole in 66.66% of the cases and partial mole in 33.33% of the cases. 81 patients (90%) achieved remission without chemotherapy and 9 patients (10%) had FIGO stage I GTT. They achieved remission with a monochemotherapy.

Conclusion: The practice of ultrasonography in the first trimester of pregnancy allows an early diagnosis of molar pregnancy and an adequate treatment and follow-up.

Keywords: chemotherapy; gestational trophoblastic tumors; human chorionic gonadotropin; hydatiform mole; ultrasonography.