GESTATIONAL TROPHOBLASTIC DISEASE - DEMOGRAPHIC, CLINICAL AND HISTOPATHOLOGICAL PROFILE AT A TERTIARY CARE HOSPITAL IN KASHMIR.

Abstract

BACKGROUND: Gestational trophoblastic disease encompasses a spectrum of tumors and tumor-like conditions characterized by abnormal proliferation of pregnancy associated trophoblastic tissues of varying abilities for invasion and spread . GTD lesions are histologically distinct and can be benign or malignant. Gestational trophoblastic neoplasms are now some of the most curable of all solid tumors, with cure rates of 90% even in the presence of widespread metastatic disease. MATERIALS AND METHODS: It was a retrospective observational study carried out at the department of obstetrics and gynecology gmc srinagar. The demographic and clinical data as well as histopathology of all the consecutive patients with molar pregnancy admitted between January, 2019 and December, 2019 were retrieved and entered into prepared proformas. RESULTS: Our study population included a total of 58 patients.The incidence in our study was 5.01/1000 deliveries.Majority of patients in our study were in the age group of 20-30 years i.e.48.3%. 58.6% patients in our study population were illeterate while as most patients belonged to lower middle class i.e. 44.8%. 24.1% patients in our study were primigravida while as 55.2% had a previous term pregnancy.Maximum patients presented in first trimester i.e. 51.7%. All patients in the study presented with a period of ammenorrhea followed by bleeding PV(72.4%), hyperemesis(44.8%) and passage of grape like vesicles(25.9%). 3 patients had acute heamorrhagic shock on presentaion. Maximum patients (84.4%) had USG documented molar pregnancy.Majority of patients(88%) belonged to low risk as per FIGO staging. 37.9%patients had blood group A while 32.8% had blood group B. On histopathology 50% patients had partial mole followed by complete mole in 38%. Invasive mole was seen in 10.3% while choriocarcinoma accounted for 1.3%.This study reported no case of PSTT. CONCLUSION:GTNs are among the rare human tumours that can be cured even in the presence of widespread dissemination. Thus an early and accurate differential diagnosis is important for patient councelling and perinatal management but also for preservation of fertility.