Gestational Trophoblastic Disease and Gestational Trophoblastic Neoplasm - An Experience at Tertiary Care Hospital

Objective: To determine the frequency of gestational trophoblastic diseases and gestational trophoblastic neoplasm, its risk factors and prognosis. Methods: This was a descriptive, cross-sectional study conducted at Civil Hospital, Karachi from March 2015 to September 2015. All cases of gestational trophoblastic disease after necessary investigations like tumour marker beta-hCG, ultrasound with classical picture of "bunch of grapes" or "snow storm" pattern and X-ray chest (for lung metastases) under went suction evacuation. In all cases specimen was sent for histopathology to confirm gestational trophoblastic disease. After primary treatment, cases were followed with beta-hCG till complete remission was achieved. During follow-up, cases were labelled as gestational trophoblastic neoplasm on the basis of International Federation of Gyne-cology and Obstetrics (FIGO) criteria. After risk scoring on World Health Organization (WHO) criteria, chemotherapy was given. Results: Out of 497 pregnant ladies, 40 were cases of gestational trophoblastic disease (8.05%). Frequency/obstetric case was 1.7% and frequency/delivery was 2.1%. Out of 40 cases 13 (32.5%) were cases of gestational trophoblastic neoplasm. Out of 13 cases of gestational trophoblastic neoplasm 9 (69.23%) were labelled as low-risk and 4 (30.76%) as high-risk cases. All cases achieved complete remission. One case of high-risk group expired. Conclusion: All women with gestational trophoblastic disease must be followed as per recommendation with serum beta human chorionic gonadotropin measurement until the levels are undetectable, for early diagnosis and optimum treatment of gestational trophoblastic neoplasm.