ABSTRACT
OBJECTIVE: To outline the geographical distribution pattern of gestational trophoblastic disease (GTD) in a referral center in Bahia, Brazil, and determine the demographics of the disease. STUDY DESIGN: We conducted a study of data retrieved from medical records of 140 GTD patients referred to our Trophoblastic Diseases Center in 2002-2007, assessing geographical distribution across health care districts, demographics, referral sources, and previous pregnancy status. RESULTS: The most common GTD types were hydatidiform mole (106, 75.7%), invasive mole (32, 22.9%), choriocarcinoma (1, 0.7%), and placental site trophoblastic tumor (1, 0.7%). GTD incidence was 8.5 in 1,000 deliveries. Most patients originated from the coastal region (East district), which includes the state capital (77.9%). The 20-34 age group predominated (65%). Education level (67.9% attended elementary school only) and employment rate (42.9%) were low. Secondary hospitals were the principal source of referral (84.3%), followed by self-referrals (15.7%). Regarding previous pregnancy status, 42.1% (n = 59) had had term pregnancy, 39.3% (n = 55) no pregnancy, 15% (n = 21) miscarriage, and 0.7% (n = 1) ectopic pregnancy; 4 patients (2.9%) had previous hydatidiform mole. CONCLUSION: GTD predominated in the peak fertility age group and among patients of unfavorable sociodemographic status.
Subject(s)
Gestational Trophoblastic Disease/epidemiology , Uterine Neoplasms/epidemiology , Adolescent , Adult , Age Distribution , Brazil/epidemiology , Child , Educational Status , Employment/statistics & numerical data , Female , Humans , Incidence , Parity , Pregnancy , Young AdultABSTRACT
BACKGROUND: Ectopic molar pregnancy is a gestational trophoblastic disease (GTD) of rare occurrence and therefore not always remembered as a diagnostic possibility. CASE: We describe a case of molar ectopic pregnancy in a primiparous woman who developed gestational trophoblastic neoplasia and required chemotherapy to achieve remission. CONCLUSION: This case stresses the important role of histopathologic examination in establishing a diagnosis of ectopic molar pregnancy. Moreover, close follow-up of human chorionic gonadotropin levels is required when a GTD is suspected.
