Evaluation of gestational trophoblastic diseases; 10 years’ experience in tertiary obstetric care center

INTRODUCTION: The aim of this study is to review the demographic characteristics and clinical outcomes of patients diagnosed with gestational trophoblastic disease (GTD).
METHODS: Data of patients with histopathologically confirmed diagnosis of GTD between 2010 and 2020 were retrospectively reviewed from hospital records.
RESULTS: There were 94 partial hydatidiform mole (PHM), 61 complete hydatidiform mole (CHM), 23 exaggerated placental site (EPS), and 22 placental site nodule (PSN) cases with the prevalence of 0.18%, 0.12%, 0.045%, and 0.039%, respectively. As gestational trophoblastic neoplasia, 1 invasive mole, 1 choriocarcinoma, and 1 placental site trophoblastic tumor were detected. While the PHM group and the CHM group were similar in terms of obstetric history, the mean age and body mass index were lower in the CHM group (p=0.04, p=0.00, respectively). Mean platelet volume and plateletcrit levels were lower and neutrophil lymphocyte ratio was higher in CHM compared to PHM (p=0.00 p=0.02, p=0.00, respectively). At diagnosis, the serum β-hCG level was higher and the gestational week was earlier, and the rate of detecting molar pregnancy by ultrasound was higher in the CHM group than in the PHM group (p=0.00, p=0.02, p=0.00, respectively). The need for a second evacuation and methotrexate chemotherapy were higher in the CHM group than in the PHM (p=0.02, p=0.00, respectively). While molar pregnancy and EPS coexistence were diagnosed in four patients, no such coexistence was found in PSN.
DISCUSSION AND CONCLUSION: Compared to PHM, CHM, which is more common in young people, requires more second evacuation or methotrexate treatment, and ultrasonography seems to be more effective in diagnosis. Unlike PSN, EPS can be seen with molar pregnancies and is rarely a cause of postpartum hemorrhage.