Incidence and outcome of gestational trophoblastic disease in lower Egypt

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.

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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

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Pregnancy-Related Emergencies

10.2310/em.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

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The clinical presentation, treatment, and outcome of patients diagnosed with possible ectopic molar gestation

International Journal of Gynecological Cancer ◽

10.1136/ijgc-00009577-200403000-00026 ◽

2004 ◽

Vol 14 (2) ◽

pp. 366-369 ◽

Cited By ~ 3

Author(s):

A. M. Gillespie ◽

E. A. Lidbury ◽

J. A. Tidy ◽

B. W. Hancock

Keyword(s):

Risk Factors ◽

Clinical Presentation ◽

Gestational Trophoblastic Disease ◽

Surgical Removal ◽

Molar Pregnancy ◽

Initial Management ◽

Trophoblastic Disease ◽

Treatment Centre ◽

History Of ◽

Park Hospital

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.

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Clinicopathological study of Gestational Trophoblastic Disease

International Journal of Research in Pharmaceutical Sciences ◽

10.26452/ijrps.v11ispl4.4467 ◽

2020 ◽

Vol 11 (SPL4) ◽

pp. 2344-2349

Author(s):

Ramesh M. Oswal ◽

Mahendra A. Patil ◽

Sujata M. Kumbhar ◽

Jyoti S. Tele ◽

Atul B. Hulwan

Keyword(s):

Risk Factors ◽

Maternal Age ◽

Hydatidiform Mole ◽

Gestational Trophoblastic Disease ◽

Histopathological Study ◽

Molar Pregnancy ◽

Complete Hydatidiform Mole ◽

Trophoblastic Disease ◽

Complete Mole ◽

Clinicopathological Study

Several potential etiologic risk factors have been evaluated for the development of complete hydatidiform mole. The two established risk factors that have emerged are extremes of maternal age and prior molar pregnancy. Advanced or very young maternal age has consistently correlated with higher rates of complete hydatidiform mole. Compared to women aged 21- 35 years, the risk of a complete mole is 1.9 times higher for women both more than 35 years and less than 21 years as well as 7.5 times higher for women more than 40 years. (49, 50) The risk of repeat molar pregnancy after 1 mole is about 1% or about 10-20 times the risk for the general population. The present study on the gestational trophoblastic disease (GTD) was carried out as it is one of the fascinating gynaecological tumours. Hence a clinicopathological study of gestational trophoblastic disease was undertaken with relevance to the histopathological study of GTD and clinical correlation.

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Gestational Trophoblastic Disease: A Hospital-Based Prospective Study to Characterize Incidence, Risk Factors, Management and Review of Literature

Indian Journal of Gynecologic Oncology ◽

10.1007/s40944-020-00396-6 ◽

2020 ◽

Vol 18 (2) ◽

Author(s):

Ashwini Neelakanthi ◽

H. C. Lokeshchandra

Keyword(s):

Risk Factors ◽

Prospective Study ◽

Gestational Trophoblastic Disease ◽

Review Of Literature ◽

Trophoblastic Disease ◽

Incidence Risk

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Malignant disease in pregnancy

Oxford Textbook of Medicine ◽

10.1093/med/9780199204854.003.1417 ◽

2010 ◽

pp. 2181-2185

Author(s):

Robin A.F. Crawford

Keyword(s):

Hydatidiform Mole ◽

Gestational Trophoblastic Disease ◽

Molar Pregnancy ◽

Live Births ◽

Trophoblastic Disease ◽

Gestational Choriocarcinoma ◽

Placental Site ◽

Cancer In Pregnancy ◽

Malignant Trophoblast ◽

In Pregnancy

Cancer in pregnancy is rare, affecting less than 1 in 1000 live births. It may be specific to pregnancy (gestational trophoblastic disease) or incidental to it, the less infrequent conditions being melanoma, lymphoma, and cervical malignancy. Gestational trophoblastic disease—a group of conditions that arise in the fetal chorion during various types of pregnancy: histologically they are categorized as (1) partial or complete hydatidiform mole, (2) gestational choriocarcinoma, or (3) placental site trophoblastic tumour. The most common of these conditions is molar pregnancy, when villi are present in association with malignant trophoblast in gestational choriocarcinoma....

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INCIDENCE AND MORTALITY RATE FOR GESTATIONAL TROPHOBLASTIC DISEASE (Preprint)

10.2196/preprints.24932 ◽

2020 ◽

Author(s):

Igor Roszkowski

Keyword(s):

Risk Factors ◽

Risk Factor ◽

Mortality Rate ◽

Gestational Trophoblastic Disease ◽

Northern Region ◽

Live Births ◽

Trophoblastic Disease ◽

The North ◽

Incidence And Mortality ◽

System Risk

BACKGROUND Gestational trophoblastic disease is a pregnancy anomaly that represents a series of invasive diseases that can metastasize or lead to death. Risk factors are genetic, racial, nutritional, and social. OBJECTIVE Analyze the number of cases of gestational trophoblastic disease, the incidence and risk factor among all patients hospitalized in Brazil from 2012 to 2017. METHODS Data collected from all hospitalizations across Brazil for hospitalized by gestational trophoblastic disease from 2012 to 2017. The incidences were calculated based on data from live births and mortality with data obtained from the Brazilian public health system. Risk factor were statistically analyzed based in race, region and age of the patients. RESULTS There were 20,534 cases of gestational trophoblastic disease with an incidence of 1.17 per 1000 live births in this period. The highest incidence was among “Asians” race (3.73 per 1000 live births; P<.001). The Brazilian regions had similar incidences, except for the Northern region, which had a lower incidence of 0.83 per 1000 live births (P=.03). The extremes of age (younger than 14 years and over 40 years) had a higher incidence compared to other women (P<.001). There were 35 deaths, and the mortality rate was 0.17% (35/20,534). The risk factors for death were living in the North region (P< .001) and “black” race (P<.001) or brown patients of color (P=.01). CONCLUSIONS The incidence found was similiar to North America and Europe. A higher incidence among "Asian" race and confirmation of higher incidence in the young and older women.

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

10.26226/morressier.5770e29dd462b80290b4c392 ◽

2016 ◽

Author(s):

Moza Al Kalbani

Keyword(s):

Risk Factors ◽

Gestational Trophoblastic Disease ◽

Histological Features ◽

Trophoblastic Disease

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Choriocarcinoma with uterine rupture presenting as acute haemoperitoneum and shock

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20170603 ◽

2017 ◽

Vol 6 (3) ◽

pp. 1141 ◽

Cited By ~ 2

Author(s):

Mamour Gueye ◽

Mame Diarra Ndiaye Gueye ◽

Ousmane Thiam ◽

Youssou Toure ◽

Mor Cisse ◽

...

Keyword(s):

Young Woman ◽

Uterine Rupture ◽

Gestational Trophoblastic Disease ◽

Uterine Perforation ◽

Molar Pregnancy ◽

Rare Neoplasm ◽

Trophoblastic Disease ◽

Intraperitoneal Bleeding ◽

Invasive Mole

Choriocarcinoma is a rare neoplasm and a malignant form of gestational trophoblastic disease. Invasive mole may perforate uterus through the myometrium resulting in uterine perforation and intraperitoneal bleeding. But uterine perforation due to choriocarcinoma is rare. We present a case of a young woman who presented 1 year after uterine evacuation of a molar pregnancy with invasive choriocarcinoma complicated by a uterine rupture and haemoperitoneum.

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Pegfilgrastim-Induced Bone Pain: A Review on Incidence, Risk Factors, and Evidence-Based Management

Annals of Pharmacotherapy ◽

10.1177/1060028017706373 ◽

2017 ◽

Vol 51 (9) ◽

pp. 797-803 ◽

Cited By ~ 7

Author(s):

Donald C. Moore ◽

Annie E. Pellegrino

Keyword(s):

Risk Factors ◽

Bone Pain ◽

English Language ◽

Data Extraction ◽

Treatment Modalities ◽

Management Options ◽

Data Synthesis ◽

Pharmacological Management ◽

Study Selection ◽

Incidence Risk

Objective: To review the incidence, risk factors, and management of pegfilgrastim-induced bone pain (PIBP). Data Sources: PubMed was searched from 1980 to March 31, 2017, using the terms pegfilgrastim and bone pain. Study Selection and Data Extraction: English-language, human studies and reviews assessing the incidence, risk factors, and management of PIBP were incorporated. Data Synthesis: A total of 3 randomized, prospective studies and 2 retrospective studies evaluated pharmacological management of PIBP. Naproxen compared with placebo demonstrated a reduction in the degree, incidence, and duration of bone pain secondary to pegfilgrastim. Loratadine was not effective in reducing the incidence of bone pain prophylactically, but a retrospective study evaluating dual antihistamine blockade with loratadine and famotidine demonstrated a decreased incidence in bone pain when administered before pegfilgrastim. Conclusion: Naproxen is effective at managing PIBP. Although commonly used, antihistamines have a paucity of data supporting their use. Dose reductions of pegfilgrastim and opioids may also be potential management options; however, data supporting these treatment modalities are scarce.

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