Diagnostic methods in gestational trophoblastic diseases.

Shrestha, Madhu.

Diagnostic methods in gestational trophoblastic diseases. - c1998. - 25p.

Thesis Report.

SUMMARY: A total number of 962 women up to 28 weeks of gestational age were studied to screen out the cases of gestational trophoblastic diseases. Among them 32 cases were found to have GTD making incidence of GTD was found 3.03/1000 pregnancies. Out of 31 cases of GTD, 26( 81.3%) women had complete and 6(18.7%) had partial molar pregnancy. The highest incidence of disease was in women between the age pf 20-24 years (3.5%) at the gestation of 13-16 weeks (4.6%) and at 2-3 gravidiity (3.9%). Socioeconomic status and antecedent pregnancy had no association with the incidence of GTD. However, no cases were preceded by molar gestation. A higher incidence of GTD (46.9%) was among the patients with the blood group a Rhesus factor positive. Rhesus negative women were not present in study population. 74.6% of patients were presented with vaginal bleeding, among them 2.3% cases belonged to GTD. Out of 20.4% of women with pain in the lower abdomen, 0.7% were cases of GTD. 0.2% patients with GTD had complain of excessive vi=omitting and 0.1% GTD cases had no symptoms. Of total cases of GTD,65.7% women had bigger or larger uterine size for gestational age,. Among them 53.2% had complete and 12.5% had partial mole. 18.7% patients had uterine size, whereas 15.6% uterine size correspond to gestational age. 34.4% women with GTD were associated to mild,15.6% to moderate and 9.4% to severe anemia. Toxemia and thyrotoxicosis were not observed among the women with GTD. Theca lutein cyst was found in 7(21.8%) women with GTD, of which 6( 18.7%) were associated with complete and 1(3.1%) with partial mole. Of total cases of GTD,75.1% were admitted with the diagnosis of molar pregnancy. Among them 59.5% were pre diagnosed by USG and 15.6% were diagnosed clinically on admission. 15.6% were presented with signs and symptoms of threatened abortion, whereas 3.1% each were presented as incomplete, enevitable and missed abortion. Out of total cases, 84.4% women proved to have molar pregnancy by USG . 3.1% was misdiagnosed as missed abortion by ultrasonogram. Of total GTD cases,20(62.5%) patients had chest x-ray done and all of them found to be without any metastatic deposit. 90.6% women with GTD had suction evacuation and 9.4% had evacuation. Hysterotomy and abdominal hysterectomy was not performed in any cases. Torsion or rupture of theca lutein cyst was not observed in women with GTD. 13(40.6%) women with GTD had check D+C. 10(31.3%) cases were with complete and 3(9.3%) with partial mole.


Eng.


Diagnostic.
Gestational.
Trophoblastic Diseases.

THS00015

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