BACKGROUND: Gestational trophoblastic disease (GTD) adversely affects pregnancy by the development of Hydatidiform mole and placental site gestational tumor. GTD is a discrete pool of epidemiological and clinicopathological entities. Therefore, every geographical region should be studied separately. The Indian subcontinent is under-reported for this disease. This paper analyses the data from a large hospital. MATERIAL/ METHODS: 92 patients with GTD were analyzed in the period from 1995 to 1999. RESULTS: The incidence of GTD was 1.31 per 1000 live births and one per 967 pregnancies irrespective of outcome. 93.5% of the patients had moderate to severe vaginal bleeding as presenting symptom, while routine antenatal ultrasonography revealed GTD in 6.5% completely asymptomatic patients. Among the major risk factors were age over 30 (p=6.3 x 10(-3), RR=2.7), previous abortion (p<0.001, RR=3.9) and multigravida (p=4.9 x 10(-6), RR=4.1). Early detection and treatment on established lines can achieve 95.7% complete response and 6.5% partial response. 17 out of 21 invasive moles (80.9%) were found with multiple abortions and mechanical interference in form of check curettage, which probably implicates repeated mechanical interference in the conversion of a mole into an invasive one. CONCLUSIONS: The present study explores the status of established host-related risk and prognostic factors in the Indian context. In cases of invasive mole, the role of repeated mechanical interference in the form of check curettage needs further evaluation.
BACKGROUND:Gestational trophoblastic disease (GTD) adversely affects pregnancy by the development of Hydatidiform mole and placental site gestational tumor. GTD is a discrete pool of epidemiological and clinicopathological entities. Therefore, every geographical region should be studied separately. The Indian subcontinent is under-reported for this disease. This paper analyses the data from a large hospital. MATERIAL/ METHODS: 92 patients with GTD were analyzed in the period from 1995 to 1999. RESULTS: The incidence of GTD was 1.31 per 1000 live births and one per 967 pregnancies irrespective of outcome. 93.5% of the patients had moderate to severe vaginal bleeding as presenting symptom, while routine antenatal ultrasonography revealed GTD in 6.5% completely asymptomatic patients. Among the major risk factors were age over 30 (p=6.3 x 10(-3), RR=2.7), previous abortion (p<0.001, RR=3.9) and multigravida (p=4.9 x 10(-6), RR=4.1). Early detection and treatment on established lines can achieve 95.7% complete response and 6.5% partial response. 17 out of 21 invasive moles (80.9%) were found with multiple abortions and mechanical interference in form of check curettage, which probably implicates repeated mechanical interference in the conversion of a mole into an invasive one. CONCLUSIONS: The present study explores the status of established host-related risk and prognostic factors in the Indian context. In cases of invasive mole, the role of repeated mechanical interference in the form of check curettage needs further evaluation.