Gestational Trophoblastic Disease in Sudanese Women A clinicopathologic Study

Abstract

Background: Gestational trophoblastic diseases are characterized by an abnormal trophoblasts proliferation. Epidemiologically, trophoblastic diseases occur with much greatest frequency in the Far East and other parts of the third world than in the Western Hemisphere. The diseases are seen in the teenage and premenopausal age groups. The objective of this study was to report on cases of gestational trophoblastic diseases received in the department of histopathology at National Health Lab in Khartoum state, its pattern, mode of presentation and histopathological features. Methods: This is a descriptive retrospective study. The slides were retrieved from archives and reviewed by the researcher with the supervisor. The slides were prepared from tissues fixed in 10% formalin and handled according to histological protocol. A hundred and nine cases were included after exclusion of cases with deficient records or missed histopathology slides and blocks. Clinical information was gathered from the records including the age, parity, type of specimen. The data were analyzed using computer program (SPSS). Results: The mean age of patients was 31.5 years, 38% of cases occurred in the age group (20-29 years) followed by 31% in the age group (30-39 years). Twenty percent of cases occurred in ladies above 40 years and 11% below 20 years. Multiparous were the most affected group (52%) followed by grand multipara (31%) Primigravidae were the least affected (17%). Pure vaginal Please purchase PDFcamp Printer on http://www.verypdf.com/ to remove this watermark. v bleeding was the main presentation in 51% and in 5% of cases it was associated with passage of vesicles and in 1% with abdominal pain. In 10% of cases the diagnosis was made during routine U/S follow up. In 32% of cases there was a previous history of abortion. Microscopically partial mole was the dominant lesion (65%), followed by complete mole 28%, choriocarcinoma 4% and invasive mole 3%. Cases of placental site trophoblastic tumors , placental site nodules , epithelioid trophoblastic tumors were not encountered in this study. Conclusion: Gestational trophoblastic disease mostly affects multipara in the second and third decades of life. Microscopy partial mole was the most common lesion (65%). Vaginal bleeding was the main presentation and abortion was a risk factor.