scholarly journals Incidence and clinicopathological profile of gestational trophoblastic disease in tertiary care centre

2018 ◽  
Vol 4 (2) ◽  
pp. 25-29
Author(s):  
Tshering Tamang ◽  
Ugyen Tshomo
Keyword(s):  
Hydatidiform Mole ◽  
Tertiary Care ◽  
Tertiary Hospital ◽  
Gestational Trophoblastic Disease ◽  
Referral Hospital ◽  
Common Symptom ◽  
Tertiary Care Centre ◽  
True Incidence ◽  
Trophoblastic Disease ◽  
National Referral Hospital

Introduction: Gestational trophoblastic disease (GTD) arises from abnormal proliferation of placental trophoblastic tissue. The aim of this study was to determine the incidence and clinicopathological profiles with treatment outcome of gestational trophoblastic disease in Jigme Dorji Wangchuck National Referral Hospital, a tertiary hospital in Bhutan. Method: A prospective and retrospective observational study was conducted over a period of 18 months. Results: A total of 121 cases of gestational trophoblastic disease were diagnosed with an incidence rate of 19.7 per 1000 deliveries. Majority comprised hydatidiform moles(115);of which, 30 (26.1%) were complete and 85(73.9%) partial moles. The mean gestational age at diagnosis of hydatidiform mole was 9.8± 1.6 weeks and the most common symptom being vaginal bleeding (72.8%). Nine (7.8%) of these progressed to gestational trophoblastic neoplasia and was strongly associated with high pre-evacuation beta-hCG level (> 100,000 mIU/ml) and larger uterine size (> 14 weeks). Conclusions: This study revealed a high incidence of gestational trophoblastic disease in national referral hospital. Further in-depth research and instituting a GTD registry can be useful to validate these findings and find the true incidence. A substantial number of molar pregnancies can progress to GTN, and thus requires strict follow-up.

scholarly journals A PROSPECTIVE STUDY ON CLINICOEPIDEMIOLOGICAL PROFILE OF MOLAR PREGNANCY IN A TERTIARY CARE HOSPITAL

2019 ◽  
Vol 3 (9) ◽  
Author(s):  
Dr. Ajit Kumar Nayak ◽  
Dr. Sumitra Hota ◽  
Dr. Maya Padhi ◽  
, Dr. Manju Kumari Jain
Keyword(s):  
Low Socioeconomic Status ◽  
Hydatidiform Mole ◽  
Tertiary Care ◽  
Single Agent ◽  
Gestational Trophoblastic Disease ◽  
Care Hospital ◽  
Molar Pregnancy ◽  
Medical College ◽  
Trophoblastic Disease ◽  
Common Time

Introduction: Gestational trophoblastic diseases (GTD) refers to a spectrum of pregnancy related trophoblastic abnormalities. The objective of this study was to determine the incidence of molar pregnancies in SCB Medical College & Hospital along with the demographics and risk factors associated and to evaluate its management and outcome.  Methods: The study was a prospective epidemiological study which includes fifty eight patients with gestational trophobastic diseases treated at the gynecological ward, S.C.B. Medical College & Hospital, Cuttack, Odisha during July 2015 to July 2017. Results: The incidence was 2.85 in 1000 deliveries in the institution. Most of the patients belonged to low socioeconomic status and in the age group of 21 to 30 years. Primigravida were more prone to the disease and no patients had history of molar in prior pregnancies. Most commonly encountered symptom was vaginal bleeding following a period of amenorrhea. Second trimester was the most common time of presentation with mean gestational age around 12 weeks. Out of 57 patients treated with suction and evacuation, 23 patients developed persistent trophoblastic disease who were further managed by methotrexate and folinic acid. Failure rate of single agent chemotherapy was 21.7% which were successfully managed by triple agent chemotherapy [EMA-CO regimen]. Conclusion: Incidence of molar pregnancies in this study was much higher as this hospital is the referral centre for South Eastern Odisha. However, proper reporting and follow up can prevent mortality associated with malignant transformation. Keywords: Beta hCG, Chemotherapy, Gestational trophoblastic disease, Hydatidiform mole, molar pregnancy

scholarly journals A clinicopathological study of gestational trophoblastic disease in a tertiary care centre of southern Assam

2021 ◽  
Vol 9 (4) ◽  
pp. 1169
Author(s):  
Sailendra K. Thakuria ◽  
Monoj K. Deka ◽  
Shah A. Sheikh
Keyword(s):  
Histopathological Examination ◽  
Wide Spectrum ◽  
Tertiary Care ◽  
First Trimester ◽  
Gestational Trophoblastic Disease ◽  
Cross Sectional Study ◽  
Tertiary Care Centre ◽  
Cross Sectional ◽  
Trophoblastic Disease ◽  
Increased Risk

Background: Gestational trophoblastic disease (GTD) covers a wide spectrum of benign and malignant conditions that arise from pregnancies with abnormal trophoblastic tissue development. It is a source of significant morbidity as well as increased risk of mortality from their complications if not identified and treated early enough. Our study aimed at the various clinicopathological features of GTDs along with their prevalence in a tertiary care centre.Methods: It was a retrospective cross-sectional study conducted over a period of 3 years from January 2017 to December 2019. All GTD cases were retrieved from department registries and analysed.Results: Out of 60 diagnosed cases of GTDs, 57 cases (95%) were Hydatiform mole. Invasive mole and choriocarcinoma were 2 cases (3%) and 1 cases (2%) respectively. Age ranged from 18-37 years. The most commonly affected age group was 20-25 years with 33 cases (55%). Most cases were presented in the first trimester presenting with bleeding per vagina. The majority of GTD cases belonged to blood group A and 50,000-<1,00,000 mlU/mL beta HCG level.Conclusions: Histopathological examination is helpful for confirmation of diagnosis.It is very important to follow up of such patients for early diagnosis of malignant trophoblastic tumors.

scholarly journals Varied presentations of gestational trophoblastic disease in Asian women: one year follow up

2016 ◽  
Vol 4 (1) ◽  
pp. 269
Author(s):  
Sumitra Bachani ◽  
Neha Pruthi ◽  
Sana Tiwari ◽  
Pratima Mittal
Keyword(s):  
Hydatidiform Mole ◽  
Tertiary Care ◽  
First Trimester ◽  
Gestational Trophoblastic Disease ◽  
Good Prognosis ◽  
Care Hospital ◽  
Asian Ethnicity ◽  
Trophoblastic Disease ◽  
One Year

Gestational trohoblastic tumors are rare tumors which constitute less than 1% cancers of female reproductive system. They have varied presentations of which hydatidiform mole is most common. The incidence is higher in Asia and South America as compared to the rest of the world. We present a total of 5 cases of Gestational trophoblastic disease (GTD) constituting 12.2% of admissions in Gynaecology ward of a tertiary care hospital over one year. There are various risk factors which predispose to GTD include maternal age less than 20 years or more than 35 years, prior GTD, prior miscarriages, Asian ethnicity and blood group A. Commonly the woman  presents with vaginal bleeding in first trimester. Sonography and β-hCG are decisive in establishing the diagnosis and further management. Follow up of the patient is very crucial. Early diagnosis and timely management results in good prognosis.

scholarly journals Adverse events following immunization with pentavalent vaccine among infants attending the immunization clinic at a tertiary hospital in Eastern India

2017 ◽  
Vol 4 (7) ◽  
pp. 2570 ◽  
Author(s):  
Shamshad Ahmad ◽  
Jayita Pal ◽  
Amiya Das ◽  
Sonalinandini Samanta
Keyword(s):  
Adverse Events ◽  
Tertiary Care ◽  
Tertiary Hospital ◽  
Common Symptom ◽  
Eastern India ◽  
Tertiary Care Centre ◽  
Public Health Importance ◽  
Childhood Diseases ◽  
Pentavalent Vaccine ◽  
The Cost

Background: Prevention of childhood diseases of public health importance is mainly achieved by immunization. Pentavalent vaccines provide immunity and protection quickly and safely. It also reduces the cost, occupational-environmental hazards as well as distress and inconvenience for the children and their parents. Adverse events following immunization (AEFI) are well established with DPT, Hep-B and Hib vaccine separately in numerous studies but when given in combination as pentavalent vaccine, data on AEFI with this is still lacking. Does there is any reduction in proportion of various minor and major AEFI after pentavalent vaccination in comparison to separate vaccines? To fill this gap in knowledge we carried an observational epidemiological study to find out the proportion and associated factors for various adverse events following immunization with pentavalent vaccine.Methods: It was a descriptive longitudinal study carried out in immunization clinic at a tertiary care centre of Eastern India. It was done between July-September 2016. Study population constitutes all the infants who attended the immunization clinic for getting vaccines. All the infants who attended the immunization clinic and were eligible for pentavalent vaccines were selected for the study.Results: A total of 230 infants participated during study period. Incidence of minor adverse events reported very high, 67 per 100 doses across all doses. Fever was most common symptom reported. Demographic character or birth history of infant had not showed an effect on occurrence of any adverse event.Conclusions: Study showed that from clinical perspective pentavalent vaccine given in a single injection has increased reactogenicity in comparison when given separately. 

Spectrum of Pathological Lesions in Uterine Specimens with Focus on Gestational Trophoblastic Disease in Karachi

2020 ◽  
Keyword(s):  
Hydatidiform Mole ◽  
Endometrial Stromal Sarcoma ◽  
Gestational Trophoblastic Disease ◽  
Cross Sectional Study ◽  
Reproductive Age ◽  
P Value ◽  
Cross Sectional ◽  
Endometrial Polyps ◽  
Trophoblastic Disease ◽  
Proliferative Endometrium

Background: The most common benign pathological lesion in women of reproductive age is uterine leiomyoma. Gestational trophoblastic disease includes tumors and tumor like lesions originating from trophoblastic tissue. The aim of this study was to find the spectrum of molar pregnancy and uterine pathologies focusing on gestational trophoblastic disease as no study has been done in the past few years. Methods: Endometrial and uterine specimens of patients (n=436) between the ages of 15-65 years were collected from a private hospital in Karachi from December 2018 to December 2019. This cross-sectional study was carried out by pathological diagnosis of patients’ samples under light microscopy using hematoxylin and eosin staining. Stratification was done about age and nature of specimen to control the effect modifiers. The post stratification Chi square test was applied and p value <0.05 was considered significant. Results: Mean age of the patients was 36.1 years ±7.8. Total 436 uterine biopsies included 260(59.6%) hysterectomies, 56(12.8%) endometrial curetting’s, 117(26.8%) evacuation specimens and 3(0.7%) polypectomies. Common pathologies included 124(28.4%) leiomyomas, 61(14%) proliferative endometrium, 52(11.9%) adenomyosis and 32(7.3%) endometrial polyps. Gestational trophoblastic disease was seen in 9(2.06%). Seven (87.5%) were partial hydatidiform moles, one (12.5%) exaggerated placental site reaction and one choriocarcinoma. Mole was common between 26-30 years with mean age of 27.2 years and prevalence was 6/100 abortions. Conclusion: Leiomyoma was the commonest (28.4%) uterine pathology followed by proliferative endometrium (14.5%). However, endometrial stromal sarcoma and endometriosis were found 0.2% each. High prevalence of mole was seen in this study. Partial mole was most common and choriocarcinoma was least common. Keywords: Hydatidiform Mole; Pathology; Prevalence.

A Study of Molar Pregnancy at Low Resource Settings of Tertiary Care Hospital Sindh

2021 ◽  
Vol 15 (7) ◽  
pp. 1547-1549
Author(s):  
Sabahat Fatima ◽  
A. G.ul Shaikh ◽  
Tahmina Mahar ◽  
Hameed-Ur-Rehman Bozdar ◽  
Sameena Memon ◽  
...  
Keyword(s):  
Body Mass Index ◽  
Body Mass ◽  
Economic Status ◽  
Gestational Trophoblastic Disease ◽  
Common Symptom ◽  
Care Hospital ◽  
Molar Pregnancy ◽  
Socio Economic Status ◽  
Trophoblastic Disease

Aim: To determine the epidemiological factors/characteristics and clinical presentation of molar pregnancy Study design: Qualitative observational / retrospective study Place and duration: Department of Obstetrics and Gynaecology Unit-II, Ghulam Muhammad Mahar Medical College Sukkur from 1st January 2016 to 31st December 2020. Methodology: Forty five diagnosed cases with molar pregnancy and aged between 18-40 years were enrolled. Patient’s details demographics age, body mass index, parity and socio economic status were recorded. The total birth records and gynecological admission for the study period were also collected from the gynaecology and labour room record books case and operational registration data were obtained, descriptive statistics examined . Results: Mean age of the patients was 31.15±7.41 years with mean body mass index 26.16±7.22 kg/m2. Mean gestational age of the patients were 25.62±9.19 weeks. Twenty seven (60%) patients were multiparous and 18 (40%) were primiparous. 30 (66.7%) were illiterate and 15(33.3%) cases were literate. There were 14(31.11%) patients belonged lower class, 18 (40%) patients belonged middle and 13(28.9%) had high socioeconomic status. Twenty nine (64.4%) were from rural area and 16 (35.6%) were from urban area. Five (11.1%) patients had previous history of gestational trophoblastic disease. Abnormal vaginal bleeding was the most common symptom found in 34(75.5%) cases followed by lower abdominal pain found in 30 (66.7%) patients, hyperemesis found in 14(31.1%) and dyspnea in 9 (20%). Thirty six (80%) patients received suction evacuation and 9 (20%) cases referred. Forty one (91.1%) patients were recovered but the rest 4 (8.9%) were lost during follow up. Conclusion: Low/middle socio-economic status, illiteracy and cases from rural areas had multiparous parity was highly effected by molar pregnancy disease and it can be controlled by early diagnose to take regular follow-up by using suction evacuation. Key words: Gestational trophoblastic disease (GTD), Molar pregnancy, Primiparous, Multiparous

scholarly journals Clinical study of multiple myeloma and treatment responses in a tertiary care centre

2021 ◽  
Vol 9 (11) ◽  
pp. 3356
Author(s):  
Immanni S. M. Giridhar ◽  
C. Deepak Yadlapalli ◽  
Muralidhar Gullipalli ◽  
Venkatesh Mushini ◽  
Yerraguntla S. Sarma ◽  
...  
Keyword(s):  
Multiple Myeloma ◽  
Treatment Options ◽  
Tertiary Care ◽  
Elevated Serum ◽  
Staging System ◽  
Stage Iiib ◽  
Common Symptom ◽  
Tertiary Care Centre ◽  
Incurable Disease ◽  
Unknown Significance

Background: Multiple myeloma (MM) evolves from Monoclonal gammopathy of unknown significance (MGUS), a premalignant clinical condition. Second to non-Hodgkin’s lymphoma, MM is the most common haematological malignancy. The aim of the study was to review the clinical profile and response of individuals treated for MM from this part of country.Methods: We evaluated data of patients with MM managed between 2013 and 2019 at a tertiary care cancer hospital in Rajamahenderi, India. Data regarding demographic variables, clinical features, disease characteristics and treatment details were collected and analysed.Results: Total of 54 patients with MM were managed. Mean age was 59.4 years. Males accounted for 63%. Bone pain (90%) was the most common symptom. Elevated serum creatinine was noted in 16.7% and M band in 42 (77.8%). X-ray of skull showed lytic lesions in 41 (75.9%). Mean haemoglobin value was 8.8±1.9 g/dl and serum calcium was 9.12 mg/dl. Majority of subjects, 44 (81.48%) belong to stage IIIA, 9 (16.67%) to stage IIIB, and 1.85% to stage IIA of Durie Salmon staging system. No response was noted in 17 (31.5%), 4 (7.4%) subjects had a progressive disease even on treatment, and 8 (14.8%) subjects had a very good partial response. Median survival of subjects belonging to DSS stage II was 17 months, IIIA was 11.037 months and stage IIIB was 17.463 months.Conclusions: MM has an early onset in India. Though MM is an incurable disease, many promising treatment options are there which lead to increase in survival. Early treatment helps in improving mortality rates, better quality of life and decreases disease burden.

What Do Women With Gestational Trophoblastic Disease Understand About the Condition?

2011 ◽  
Vol 21 (1) ◽  
pp. 161-166 ◽  
Author(s):  
Lesley Stafford ◽  
Fiona Judd
Keyword(s):  
Health Literacy ◽  
Negative Impact ◽  
Hydatidiform Mole ◽  
Complementary Therapy ◽  
Gestational Trophoblastic Disease ◽  
Self Report ◽  
Medical Procedure ◽  
Healthy Children ◽  
Cross Sectional ◽  
Trophoblastic Disease

Introduction:Little is known about patients' understanding of the causes, treatments, and implications of gestational trophoblastic disease (GTD). Clinical observation suggests that such health literacy is limited. We report on the perceptions of causes and treatment of GTD and its impact on fertility and reproductive outcomes.Methods:Cross-sectional analysis of 176 Australian women previously diagnosed with GTD (no longer receiving follow-up/treatment) recruited from a state-wide registry. Participants comprised 149 (85%) women with GTD who did not require chemotherapy and 27 (15%) women who required chemotherapy for malignancy or persistent molar disease. Data were collected from medical records and via self-report questionnaire.Results:Participants were 94 women (53%) with partial mole, 75 (43%) with complete mole, 4 (2%) with choriocarcinoma, and 3 (2%) with hydatidiform mole not otherwise specified. Mean (SD) age at diagnosis and time since diagnosis were 32.1 (6.3) and 4.7 (3.3) years, respectively. Chance/bad luck was the most endorsed cause (n = 146, 83%); 23 (13%) thought GTD was hereditary and 10 (6%) identified a chromosomal etiology. Between 24% and 32% were unsure of the role of alcohol/drugs, venereal diseases, smoking, pollution, contraceptives, and lowered immunity. Surgical/medical procedure (n = 127, 72%) and healthy diet (n = 53, 30%) were the most endorsed treatments. Between 18% and 23% were unsure of the treatment effectiveness of diet, vitamins, exercise, complementary therapy, and contraception. All women treated with chemotherapy understood the rationale thereof; 23 (85%) perceived chemotherapy to be successful, and 19 (70%) could name the agent. Few women perceived a negative impact on their fertility (n = 28, 16%); 52 (30%) were reluctant to conceive again and 100 (57%) questioned their ability to have healthy children. After diagnosis, 111 (63%) had at least 1 live birth.Conclusions:Notwithstanding limitations, this study is the largest of its type to date. These descriptive data enhance our understanding of patients' experience on GTD, highlight the scope of GTD health literacy, and may be useful for clinicians to adjust the content of their patient education.

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