GESTATIONAL TROPHOBLASTIC DISEASE AT SQUH: PREVALENCE, RISK FACTORS, HISTOLOGICAL FEATURES, SONOGRAPHIC FINDINGS AND OUTCOME

The objective of this study was to determine the clinical presentation, treatment, and outcome of patients diagnosed with possible ectopic molar gestation registered with the Trophoblastic Disease Screening and Treatment Centre, Weston Park Hospital, Sheffield between 1986 and 2000. From the 5581 women registered, those with a diagnosis of ectopic molar pregnancy were identified from a computer database. Information regarding the relevant history of each patient and the clinical presentation, treatment, and outcomes of gestational trophoblastic disease (GTD) was determined by reviewing referral forms, case notes, and pro formas completed by the referring gynecologist. Histological review of the cases was undertaken where possible. Suspected ectopic molar gestations comprised 31/5581 (0.55%) of registrations. Known risk factors for ectopic pregnancy were identified in 79% of cases. Central histological review confirmed only six cases of GTD: three choriocarcinoma and three early complete moles. Four patients subsequently required chemotherapy. All patients are now in complete remission. We conclude that ectopic GTD is uncommon, with a UK incidence of approximately 1.5 per 1,000,000 births. Initial management is usually surgical removal of the conceptus, pathological suspicion of the diagnosis and registration with a screening center. Chemotherapy may be required and the prognosis is excellent.

Download Full-text

Understanding and management of gestational trophoblastic disease

F1000Research ◽

10.12688/f1000research.14953.1 ◽

2019 ◽

Vol 8 ◽

pp. 428 ◽

Cited By ~ 6

Author(s):

Fen Ning ◽

Houmei Hou ◽

Abraham N. Morse ◽

Gendie E. Lash

Keyword(s):

Risk Factors ◽

Treatment Options ◽

Gestational Trophoblastic Disease ◽

Abnormal Development ◽

Trophoblastic Disease ◽

Trophoblastic Tissue

Gestational trophoblastic disease or neoplasia covers a spectrum of benign and malignant conditions arising from pregnancies with highly abnormal development of trophoblastic tissue. In this brief review, we discuss the different features of these different conditions and their origins and risk factors and introduce some of the more novel and controversial treatment options currently being explored.

Download Full-text

Morbidity and mortality of patients suffering from gestational trophoblastic diseases at the Clinic of gynecology and obstetrics, Clinical center of Serbia in the period from 2000 to 2007

Medicinski pregled ◽

10.2298/mpns1112579l ◽

2011 ◽

Vol 64 (11-12) ◽

pp. 579-582 ◽

Cited By ~ 1

Author(s):

Biljana Lazovic ◽

Vera Milenkovic ◽

Ljiljana Mirkovic

Keyword(s):

Risk Factors ◽

Gestational Trophoblastic Disease ◽

Morbidity And Mortality ◽

Trophoblastic Disease ◽

Gynecology And Obstetrics ◽

Heterogenous Group ◽

Clinical Center ◽

Trophoblastic Diseases ◽

Potential Risk Factors ◽

Gestational Trophoblastic Diseases

Introduction. Gestational trophoblastic disease is a heterogenous group of diseases with malignant potential. The aim of this retrospective study was to evaluate potential risk factors in pathogenesis of gestational trophoblastic disease, its morbidity and mortality as well as treatment results. Method. We investigated 82 patients who were treated at the University Clinic of Gynecology and Obstetrics Clinical Center of Serbia from Jan 1st 2000 to Dec 31st 2007. The data were collected from their hospital charts and referred to gynecological anamnesis, diagnosis, protocols of operated patients, diagnosis, histopathological findings, decisions of expert team for trophoblastic disease and hospital discharge. Results. The incidence was 1.5 per 1000 deliveries. The most frequent finding was hydatiform mole (59.8%). The patients were treated by chemotherapy and surgery. All patients survived. Conclusion. The maternal age and a larger number deliveries and abortions are risk factors for gestational trophoblastic disease. The incidence in our clinic is approximately equal to the incidence in western countries in this period.

Download Full-text

RISK FACTORS FOR GESTATIONAL TROPHOBLASTIC DISEASE IN ITALY

American Journal of Epidemiology ◽

10.1093/oxfordjournals.aje.a114018 ◽

1985 ◽

Vol 121 (3) ◽

pp. 457-464 ◽

Cited By ~ 32

Author(s):

CARLO LA VECCHIA ◽

SILVIA FRANCESCHI ◽

FABIO PARAZZINI ◽

MONICA FASOLI ◽

ADRIANO DECARLI ◽

...

Keyword(s):

Risk Factors ◽

Gestational Trophoblastic Disease ◽

Trophoblastic Disease

Download Full-text

Pregnancy-Related Emergencies

DeckerMed Surgery ◽

10.2310/surg.4368 ◽

2019 ◽

Author(s):

Amy Hideko Kaji

Keyword(s):

Risk Factors ◽

Ectopic Pregnancy ◽

Hyperemesis Gravidarum ◽

Gestational Trophoblastic Disease ◽

Treatment Modalities ◽

Free Fluid ◽

Molar Pregnancy ◽

Hypertensive Disorders Of Pregnancy ◽

Trophoblastic Disease ◽

Hypertensive Disorders

This review provides an overview of spontaneous abortion, ectopic pregnancy, gestational trophoblastic disease or molar pregnancy, hyperemesis gravidarum, placental abruption, placental previa, hypertensive disorders of pregnancy, and amniotic fluid embolism. Assessment and stabilization, diagnosis, treatment and disposition, and outcomes are discussed. Tables include classifications of abortion or miscarriage, differential diagnosis of patients presenting with vaginal bleeding during pregnancy, risk factors for ectopic pregnancy, treatment modalities for hyperemesis gravidarum, classification of hypertensive disorders of pregnancy, and risk factors for preeclampsia and eclampsia. Figures show ectopic pregnancy on a sonogram, free fluid in hepatorenal fossa on a focused abdominal sonogram in trauma, double decidual sign in a normal intrauterine pregnancy, pseudogestational sac in an ectopic pregnancy, and “snowstorm” appearance of molar pregnancy on a sonogram. This review 5 figures, 13 tables, and 68 references. Keywords: abortion, ectopic, gestational trophoblastic disease, abruption, previa, ecclampsia

Download Full-text

Hyperthyroidism in gestational trophoblastic disease – a literature review

Thyroid Research ◽

10.1186/s13044-021-00092-3 ◽

2021 ◽

Vol 14 (1) ◽

Author(s):

Jarett Vanz-Brian Pereira ◽

Taylor Lim

Keyword(s):

Risk Factors ◽

Early Detection ◽

Gestational Trophoblastic Disease ◽

Thyroid Stimulating Hormone ◽

Cochrane Library ◽

Thyroid Storm ◽

High Risk Women ◽

Trophoblastic Disease ◽

Full Text Review ◽

Thyrotropic Activity

Abstract Objective Gestational trophoblastic disease (GTD) is a group of pregnancy-related disorders that arise from abnormal proliferation of placental trophoblast. Some patients with GTD develop hyperthyroidism, a rare but potentially life-threatening complication requiring early detection and management. Existing literature on hyperthyroidism in GTD is scant. This review aims to analyse the epidemiology, pathophysiology and management of this phenomenon. Methods A comprehensive search of MEDLINE, EMBASE and Cochrane Library was performed to obtain articles that explored hyperthyroidism in GTD. A total of 405 articles were screened and 228 articles were considered for full-text review. We selected articles that explored epidemiology, pathophysiology and outcomes/management of hyperthyroidism in GTD. Results The pathophysiology of hyperthyroidism in GTD is well-investigated. Placental trophoblastic tissue secretes excessive hCG, which is structurally similar to thyroid stimulating hormone and also has enhanced thyrotropic activity compared to normal hCG. The incidence and prevalence of hyperthyroidism in GTD varies worldwide, with lower rates associated with high uptake of early antenatal screening and early GTD detection. No clear risk factors for hyperthyroidism in GTD were identified. While hyperthyroidism can be definitively managed with surgical evacuation of the uterus, severe complications associated with hyperthyroidism in GTD have been reported, including thyroid storm-induced multi-organ failure, ARDS, and pulmonary hypertension. Conclusion Early detection of GTD is critical to prevent development of hyperthyroidism and its associated complications. Hyperthyroidism should be recognised as an important perioperative consideration for women undergoing surgery for GTD, and requires appropriate management. Future studies should explore risk factors for hyperthyroidism in GTD, which may facilitate earlier identification of high-risk women.

Download Full-text

Faculty Opinions recommendation of Investigation of Risk Factors, Stage and Outcome in Patients with Gestational Trophoblastic Disease since 2001 to 2011 in Iran-Yazd.

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.735435515.793558476 ◽

2019 ◽

Author(s):

Gendie Lash

Keyword(s):

Risk Factors ◽

Gestational Trophoblastic Disease ◽

Trophoblastic Disease

Download Full-text

Incidence and outcome of gestational trophoblastic disease in lower Egypt

African Health Sciences ◽

10.4314/ahs.v20i1.12 ◽

2020 ◽

Vol 20 (1) ◽

pp. 73-82

Author(s):

Ahmed Zakaria ◽

Reda Hemida ◽

Waleed Elrefaie ◽

Ehsan Refaie

Keyword(s):

Risk Factors ◽

Patient Characteristics ◽

Gestational Trophoblastic Disease ◽

Treatment Modalities ◽

Progression Rate ◽

Molar Pregnancy ◽

Live Births ◽

Trophoblastic Disease ◽

Rate Of Progression ◽

Incidence Risk

Background. Gestational trophoblastic disease (GTD) defines a spectrum of proliferative disorders of trophoblastic epitheli- um of the placenta. Incidence, risk factors, and outcome may differ from one country to another. Objective. To describe incidence, patient characteristics, treatment modalities, and outcome of GTD at Mansoura University which is a referral center of Lower Egypt. Methods. An observational prospective study was conducted at the GTD Clinic of Mansoura University. The patients were recruited for 12 months from September 2015 to August 2016. The patients’ characteristics, management, and outcome were reported. Results. We reported 71 clinically diagnosed GTD cases, 62 of them were histologically confirmed, 58 molar (33 CM and 25 PM) in addition to 4 initially presented GTN cases. Mean age of the studied cases was 26.22 years ± 9.30SD. Mean pre-evacu- ation hCG was 136170 m.i.u/ml ±175880 SD. Most of the cases diagnosed accidentally after abnormal sonographic findings (53.2%). Rate of progression of CM and PM to GTN was 24.2% and 8%, respectively. Conclusion. The incidence of molar pregnancy and GTN in our locality was estimated to be 13.1 and 3.2 per 1000 live births respectively. We found no significance between CM and PM regarding hCG level, time to hCG normalization, and progression rate to GTN. Keywords. Molar pregnancy; incidence; outcome.

Download Full-text