PROFILE OF GESTATIONAL TROPHOBLASTIC DISEASES IN TWO TEACHING HOSPITALS IN ADDIS-ABABA, ETHIOPIA

Abstract

PROFILE OF GESTATIONAL TROPHOBLASTIC DISEASES IN TWO TEACHING HOSPITALS IN ADDIS-ABABA, ETHIOPIA

Dereje Negussie^l, MD, Tefera Belachew², MD, MSc,DILSTHM

ABSTRACT

BACKGROUND: Gestational Trophoblastic Disease is one of the causes of maternal morbidity and mortality among women in the reproductive age group. However the magnitude, clinical features and risk factors are not well documented in Ethiopian setting. This study was conducted to describe these important aspects of the disease entity in two teaching hospitals in Addis-Ababa.

Patients and Methods: Data of a five-year record from December 1, 1994-November 30, 1999 , of two teaching hospitals was abstracted and analyzed in April 2000 to determine the magnitude, the clinical pattern and associated factors of gestational trophoblastic disease. The data were cleaned, edited and entered in to a computer and analyzed using EPI-INFO version 6 statistical package. Statistical tests were employed where appropriate at the level of significance of 5%.

RESULTS: The magnitude of gestational trophoblastic disease was found to be 2.8 per 1000 deliveries; patient's age ranged from 14 to 53 years with median age of 34.5 years and mean (±SD) age of 30.9(216.5)years . Forty-seven (50.5%) have five or more pregnancies while 44 (47.3%) were grand multiparas. Parity, gravidity and age of the mother had a statistically significant association with gestational trophoblastic diseases (P<0.0001). Thirty-Five (37.6%) had experienced at least one abortion. Vaginal bleeding was the commonest presenting symptom in 84 (90.3%) of the patients. Hydatidiform mole was the commonest disease accounting for 67 (72.0%), followed by choriocarcinoma 14 (15.0%) and invasive mole 12 (12.9%). Various modalities of treatments, including evacuation using medical and surgical methods and chemotherapy were used. Forty-three (46.2%) of the patients had at least two or more follow-up and the final outcome of the disease was not known in 70 (75.3%) which is a limitation in his study.

CONCLUSION: The magnitude of gestational trophoblastic disease in this study, which is 2.8 per 1000 deliveries, is low. The disease was more commonly seen in those with history of two or more abortions, five or more pregnancies and in those who were 35 years and above. Compared to other studies, lower remission rate and follow up of cases were observed. Only small numbers of patients were managed with chemotherapy while it's the mainstay of treatment. We recommend use of chemotherapeutic agents and laarge scale health facility based study of this disease.