Outcomes and challenges in the management of gestational trophoblastic disease in a tertiary institution in Nigeria
Context: Gestational Trophoblastic Diseases are a spectrum of interrelated diseases disorders that arise from abnormal pregnancy and are characterized by excessive elevation of Human Chorionic Gonadotrophins. They include both benign and malignant forms; hydatidiform mole, Invasive mole, Placental Site Trophoblastic (PSTT) tumour and Choriocarcinoma.
Objective: The objective of this study was to present the outcomes and challenges encountered in the management of GTDs in a tertiary centre in South-western part of Nigeria.
Study Design, Setting and Subjects: This was a retrospective study of the cases of gestational trophoblastic disease managed at Obafemi Awolowo University Teaching hospitals complex, Ile Ife between 2009 and 2013. Data were retrieved from the case records and telephone calls were put across the patients to enquire about the state of health of the patients. Data was analysed using SPSS version 20.
Main Outcome Measures: The main outcome measures were the incidence of GTDs, outcomes and challenges encountered in the management of patients with gestational trophoblastic disease.
Results: A total of 27 women were managed for GTDs; 22 had hydatidiform moles and 5 were managed for choriocarcinoma. The mean age of the patients was 31.9 years SD 6.94, mean parity 2 SD 1.53; mean duration of amenorrhoea was 15.7 weeks SD 4.92. The most common presenting symptom was vaginal bleeding in 81.5% of cases. Non-adherence to prescribed treatment was high as over half of the patients with molar pregnancy was lost to follow up after molar evacuation. Mortality was also high among patients with GTDs as 60% of the patients with choriocarcinoma died during treatment.
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