Gestational Trophoblastic Diseases in a Teaching Hospital in Northern, Nigeria
American Journal of BioScience
Volume 3, Issue 1, January 2015, Pages: 7-10
Received: Dec. 6, 2014; Accepted: Dec. 22, 2014; Published: Jan. 20, 2015
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Authors
Ibrahim Yakasai, Department of Obstetrics and Gynaecology, Bayero University Kano/Aminu Kano Teaching Hospital Kano, Nigeria
Idris Abubakar, Department of Obstetrics and Gynaecology, Bayero University Kano/Aminu Kano Teaching Hospital Kano, Nigeria
Yunus Eze, Aminu Kano Teaching Hospital Kano, Nigeria
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Abstract
Background: Gestational trophoblastic diseases (GTD) is a spectrum of pregnancy-related premalignant disorders of complete and partial hydatidiform mole, and the malignant disorders of invasive mole, choriocarcinoma, and the rare placental-site trophoblastic tumour. Objective: This study was carried out to determine the incidence of gestational trophoblastic disease, the clinical features and management outcome at the Aminu Kano Teaching Hospital, Kano, Nigeria. Materials and Methods: This was a retrospective study of the demographic and clinical data as well as management outcome of all patients with gestational trophoblastic disease managed between January, 2008 and December, 2012 at the Aminu Kano Teaching Hospital. Kano,Nigeria Results: There were 103 cases of GTD and 22,680 deliveries; giving an incidence of GTD as 4.5 per 1000 deliveries. Among them, 69 (67.0%) cases were hydatidiform mole while Choriocarcinoma was diagnosed in 34 cases (33.0%). The antecedent pregnancy among the cases of choriocarcinoma were hydatidiform mole in 18 cases (52.9%), miscarriage in 10 cases (29.4%) and ectopic pregnancy in 1 case (3.0%) and full term pregnancy in 5(14.7%) patients. GTD was commoner at the extremes of reproductive age. Hydatidiform mole was high 37(53.6%) in those aged 24 years and below, while choriocarcinoma was high 13(38.2%) in 45 - 49 years age group. The most common presenting symptom was vaginal bleeding occurring in all the cases, while anaemia was the most common complication. Suction evacuation and follow up (67.0%) was the mode of treatment in all cases of molar pregnancy. Only cases of choriocarcinoma 34 (33.0%) had chemotherapy, 11(32.4%) cases had single agent while 23 cases (67.6%) had multi-agent chemotherapy. There were seven maternal deaths in this study, given a case fatality of 6.8%. Conclusion: The incidence of GTD in this study was 4.5 per 1000 deliveries. Vaginal bleeding was the commonest presenting symptom. Early diagnosis and appropriate treatment of this disease has an excellent prognosis, while late presentation was associated with high maternal mortality as found in this study.
Keywords
Molar Pregnancy, Choriocarcinoma, Maternal Mortality
To cite this article
Ibrahim Yakasai, Idris Abubakar, Yunus Eze, Gestational Trophoblastic Diseases in a Teaching Hospital in Northern, Nigeria, American Journal of BioScience. Vol. 3, No. 1, 2015, pp. 7-10. doi: 10.11648/j.ajbio.20150301.12
References
[1]
Seckl MJ, Sebire NJ, Berkowitz RS. Gestational trophoblastic disease. Lancet. 2010 Aug 28; 376(9742):717-29
[2]
Eniola OA, Mabayoje P, Ogunniyi SO. Hydatidiform mole in Ile-Ife, Nigeria: a 10-year review. J Obstet Gynaecol. 2009 May;29(4):322
[3]
Yakasai IA, Adamu N, Galadanchi HS. Ruptured tubal molar pregnancy. Niger J Clin Pract 2012;15:491-3
[4]
Nkyekyer K. Gestational Trophoblastic Disease. In: Comprehensive Gynaecology In The Tropics.Kwawukume EY,Emuveyan EE (Eds).2005;498-511
[5]
Audu BM, Takai IU, Chama CM, Bukar M, Kyari O. Hydatidiform mole as seen in a university teaching hospital: a 10-year review.
[6]
Mbamara S.U, Obiechina NJA, Eleje G.U, Akabuike C.J, Umeononihu O.S. Gestational Trophoblastic Disease in Tertiary Hospital Nnewi Southeast Nigeria. Niger Med. J. 2009; 50(4):
[7]
Sebire N J, Seckl M J Gestational trophoblastic disease: current management of hydatidiform mole. BMJ 2008; 337:1193.
[8]
Paola A. Gestational Trophoblastic Disease.In: Current diagnosis &treatment obstetrics and gynaecology. Alan H.D,Lauren N, Murphy TG,Neri L (Eds). 10th edition McGraw Hill,New York. 2007;885-895
[9]
Ocheke AN, Jonah M, and Alexander OU. Hydatidiform mole in Jos, Nigeria. Niger Med J. 2011 Oct-Dec; 52(4): 223–226
[10]
Smith HO, Kohorn E, Cole LA. Choriocarcinoma and gestational trophoblastic disease. Obstet Gynecol Clin North Am. Dec 2005;32(4):661-84
[11]
Richa S. Hydatidiform Mole. Bedside Obstetrics & Gynaecology. First edition 2010.Jaypee brother Medical Publishers (P) LTD. New Delhi.p135- 148.
[12]
Soper JT. Gestational trophoblastic disease. Obstet Gynecol. Jul 2006; 108(1):176-87
[13]
John RL. Gestational trophoblastic disease I:epidemiology, pathology, clinical presentation and diagnosis of gestational trophoblastic disease, and management of hydatidiform mole. Am J of Obstet Gynecol. 2010; 203(6): 531-539
[14]
Foulmann K, Guastalla JP, Caminet N. What is the best protocol of single-agent methotrexate chemotherapy in nonmetastatic or low-risk metastatic gestational trophoblastic tumors? A review of the evidence. Gynecol Oncol. Jul 2006;102(1):103-10.
[15]
Cavaliere A, Ermito S, Dinatale A, Pedata R. Management of molar pregnancy. Journal of Prenatal Medicine. 2009; 3 (1): 15-17.
[16]
Anuma ON, Umeora OUJ, Obuna JA, Agwu UM. Profiling Gestational Trophoblastic Disease in a Tertiary Hospital in South-East Nigeria. Niger J Clin Pract. 2008 Jun;11(2):134-8
[17]
Khairunnisa N, Gulfareen H, Nizamuddin M, Ambreen H. Gestational Trophoblastic Disease: Experience at Nawabshah Hospital. J Ayub Med Coll Abbottabad 2009; 21(1) 94-7.
[18]
Bugti QA, Baloch N, Baloch MA. Gestational Trophoblastic Disease in Quetta. Patistan J. Med. Res. 2005; 44(2):200 - 4.
[19]
Obiechina NJA, Udigwe GO, Obi RA. Molar pregnancy a ten yrar review at Onitsha Nigeria. Journal of Medical Investigation and Practice(JOMIP)2001;13:26-31
[20]
Ben-Arie A, Deutsch H, Volach V, Peer G, Husar M, Lavie O, et al. Reduction of post molar gestational trophoblastic neoplasm by early diagnosis and treatment. J Reprod Med. 2009;54:151–4
[21]
Nevin J. Gestational trophoblastic disease. In: Bloch B, Dehaeck K, Soeters R, editors. Manual of Practical Gynecological Oncology. London: Chapman and Hall Medical; 1995. pp. 130–46.
[22]
Bianconi MI, Otero S, Moscheni O, Alvarez L, Storino C, Jankilevich G. Gestational trophoblastic disease:a 21-year review of the clinical experience at an Argentinean public hospital. J Reprod Med. 2012; 57(7-8):341-9.
[23]
RCOG Green-top Guideline No.38, February 2010: THE MANAGEMENT OF GESTATIONAL TROPHOBLASTIC DISEASE.
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