The pattern of benign gestational trophoblastic disease in Karachi.

A hospital based epidemiological study of benign gestational trophoblastic disease i.e., both complete and partial hydatidiform mole was undertaken at 8 hospitals. The frequency of the disease was found to be 3.89/1000 pregnancies and was found to be higher--1 in 237 deliveries in the economically deprived women admitted to a free Government Hospital, compared to only 1 in 471 deliveries in a Private, fee-for-service hospital. Risk factors identified, were: age above 35 years (OR = 7.39, CL 5.54-9.87); or under 20 years (OR = 2.14, CL = 1.60-2.85), history of previous molar pregnancy (OR = 18.44, CL = 49.4-74.09), past history of abortions (OR = 1.96, CL = 1.49-2.57) and recurrent abortions (OR = 3.26, CL = 1.82-5.77). Blood group A was also found to be a significant risk factor (OR = 1.6, CL = 1.01-2.53). Progression to gestational trophoblastic tumor was found in 3% patients with hydatidiform mole. A plea is made for earlier diagnosis at asymptomatic stage, to reduce morbidity; histopathological examination of all abortuses will help identify complete and partial moles which would otherwise be overlooked. Finally, improvement in follow-up system and establishment of a data base is recommended.