Gestational trophoblastic disease: experience at a tertiary care hospital of Sindh.

OBJECTIVE To determine the frequency, clinical presentation and management outcomes of Gestational Trophoblastic Disease (GTD). STUDY DESIGN Descriptive case series. PLACE AND DURATION Department of Gynaecology and Obstetrics, Liaquat University of Medical and Health Sciences, Jamshoro, from March 2003 to March 2004. PATIENTS AND METHODS The case records of all the gestational trophoblastic cases during study period were analyzed regarding their illness history, clinical examination, investigations, treatment and follow-up. The main outcomes were measured in terms of duration, antecedent pregnancy, investigations, treatment and the follow-up. RESULTS There were a total of 1030 obstetric admissions during the study period, which included 23 cases of trophoblastic disease. Hence, frequency of GTD was 1 per 45 live births. Of these 23 cases, 19 (82.6%) patients had hydatidiform mole and 4 patients had malignant trophoblastic disease. Eight patients (34.7%) received chemotherapy while rest of the patients had suction evacuation and follow-up. Among all patients, 21 (91.3%) fully recovered and 2 (8.69%) died because of extensive disease; metastasis extending upto brain. CONCLUSION Frequency of trophoblastic disease was high in this series compared to world and national literature. Therefore, emphasis should be on the early diagnosis of disease as proper management in the early stages strongly influences the outcome of disease. Suction evacuation and follow-up are ideal treatments for benign trophoblastic disease.