study on gestational trophoblastic disease [GTD]

ABSTRACT

To review and critically evaluate, the incidence, epidemiology, clinical pattern, diagnosis, management, complications and surveillance of GTD in our set up. Design: A study of 20 cases of GTD managed in two years 1993-1994. Setting: Department of Obstetrics and Gynecology Postgraduate Medical Institute/Service Hospital, Lahore. 20 Patients of GTD admitted in the ward. Main outcome measures: Incidence, clinical features, diagnosis, management, complications and follow-up. During this period four thousand three hundred and forty two patients delivered giving an incidence of GTD as 1217 births. Nineteen cases were of Hydatidiform mole and 1 of Choriocarcinoma. One of the patients later on developed invasive mole. Eighteen patients were managed by suction curettage, one by hysterectomy. In a 42 years patient with persistent high serum beta HCG, invasive mole was suspected which proved on hysterectomy and histopathology Choriocarcinoma was diagnosed on histopathology of curettings in a 45 years patient. Chemotherapy 'MAC' [methotrexate, actinomycin, chlorambucil] regimen was given but hysterectomy was performed for heavy vaginal bleeding. Strict follow up was advised, but patients compliance remained unsatisfactory. One patient delivered a healthy baby girl at term. The diagnosis was made from clinical features, ultrasonography, serum beta HCG. Suction curettage is the management of choice for hydatidiform mole. Regular follow up of cases is essential