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A retrospective study of molar pregnancy cases submitted to our clinic: 5 years clinical experience

Year 2014, Volume: 5 Issue: 17, 18 - 23, 03.03.2015
https://doi.org/10.17944/mkutfd.18119

Abstract

Aim: In this study, we aimed to determine the incidence of gestational trophoblastic disease by using data of patients who were treated for molar pregnancies. Material and methods: . The patients diagnosed as gestational trophoblastic disease between January 2009- January 2014 was evaluated retrospectively. Patients’ age, gravidity, parity and aborts were noted. Patients’ history, ultrasonographic findings, β HCG and laboratory results, hystopathology findings, treatment modalities and β HCG for following-up were recorded. Results: The incidence of molar pregnancy was found as 8 per 1000 deliveries. The mean age of patients was 28.72 ±7,5 and mean gestastional week was 10±2,4. β HCG values was found between 240 and 145100. Out of all patients, 20 (33.3%) had ultrasonographic signs of molar pregnancy. Pathology results revealed partial mole in 45 (75%), complete mole in 12 (20%) patients and choriocarcinoma in 3 (5%) patients. No mortality related to disease and complications was observed

References

  • Kohorn EI. Negotiating a staging and risk factor scoring system for gestational trophoblastic
  • neoplasia. A progress report. The Journal of reproductive medicine. 2002;47(6):445-50.
  • Berkowitz RS, Goldstein DP. Current management of gestational trophoblastic diseases.
  • Gynecologic oncology. 2009;112(3):654-62.
  • Davis JR, Surwit EA, Garay JP, Fortier KJ. Sex assignment in gestational trophoblastic
  • neoplasia. American journal of obstetrics and gynecology. 1984;148(6):722-5.
  • Surti U, Szulman AE, O'Brien S. Dispermic origin and clinical outcome of three complete
  • hydatidiform moles with 46,XY karyotype. American journal of obstetrics and gynecology.
  • ;144(1):84-7.
  • Hammond CB, Evans AC. Gestational trophoblastic disease. Current therapy in endocrinology
  • and metabolism. 1997;6:603-6.
  • Tham BW, Everard JE, Tidy JA, Drew D, Hancock BW. Gestational trophoblastic disease in
  • the Asian population of Northern England and North Wales. BJOG : an international journal of
  • obstetrics and gynaecology. 2003;110(6):555-9.
  • Lybol C, Centen DW, Thomas CM, ten Kate-Booij MJ, Verheijen RH, Sweep FC, et al. Fatal
  • cases of gestational trophoblastic neoplasia over four decades in the Netherlands: a retrospective
  • cohort study. BJOG : an international journal of obstetrics and gynaecology. 2012;119(12):1465-72.
  • Cakmak B, Toprak M, Nacar MC, Koseoglu RD, Guneri N. Incidence of gestational
  • trophoblastic disease in Tokat province, Turkey. Journal of the Turkish German Gynecological
  • Association. 2014;15(1):22-4.
  • Seckl MJ, Sebire NJ, Berkowitz RS. Gestational trophoblastic disease. Lancet.
  • ;376(9742):717-29.
  • Palmer JR. Advances in the epidemiology of gestational trophoblastic disease. The Journal of
  • reproductive medicine. 1994;39(3):155-62.
  • Therasakvichya S. Gestational trophoblastic disease in 2005. Journal of the Medical
  • Association of Thailand = Chotmaihet thangphaet. 2005;88 Suppl 2:S119-23.
  • Martin BH, Kim JH. Changes in gestational trophoblastic tumors over four decades. A Korean
  • experience. The Journal of reproductive medicine. 1998;43(1):60-8.
  • Hayashi K, Bracken MB, Freeman DH, Jr., Hellenbrand K. Hydatidiform mole in the United
  • States (1970-1977): a statistical and theoretical analysis. American journal of epidemiology.
  • ;115(1):67-77.
  • Sebire NJ, Foskett M, Fisher RA, Rees H, Seckl M, Newlands E. Risk of partial and complete
  • hydatidiform molar pregnancy in relation to maternal age. BJOG : an international journal of
  • obstetrics and gynaecology. 2002;109(1):99-102.
  • Sand PK, Lurain JR, Brewer JI. Repeat gestational trophoblastic disease. Obstetrics and
  • gynecology. 1984;63(2):140-4.
  • Tierney JP, Welsh J, Owen P. Management of early pregnancy loss--a complete audit cycle.
  • Journal of obstetrics and gynaecology : the journal of the Institute of Obstetrics and Gynaecology.
  • ;26(3):229-32.
  • Hou JL, Wan XR, Xiang Y, Qi QW, Yang XY. Changes of clinical features in hydatidiform
  • mole: analysis of 113 cases. The Journal of reproductive medicine. 2008;53(8):629-33.
  • Nayeri UA, West AB, Grossetta Nardini HK, Copel JA, Sfakianaki AK. Systematic review of
  • sonographic findings of placental mesenchymal dysplasia and subsequent pregnancy outcome.
  • Ultrasound in obstetrics & gynecology : the official journal of the International Society of Ultrasound
  • in Obstetrics and Gynecology. 2013;41(4):366-74.
  • Fowler DJ, Lindsay I, Seckl MJ, Sebire NJ. Routine pre-evacuation ultrasound diagnosis of
  • hydatidiform mole: experience of more than 1000 cases from a regional referral center. Ultrasound in obstetrics & gynecology : the official journal of the International Society of Ultrasound in Obstetrics
  • and Gynecology. 2006;27(1):56-60.
  • Sebire NJ, Rees H, Paradinas F, Seckl M, Newlands E. The diagnostic implications of routine
  • ultrasound examination in histologically confirmed early molar pregnancies. Ultrasound in obstetrics
  • & gynecology : the official journal of the International Society of Ultrasound in Obstetrics and
  • Gynecology. 2001;18(6):662-5.
  • Berkowitz RS. Gestational trophoblastic tumors and malignant ovarian germ cell tumors.
  • Current opinion in oncology. 1989;1(1):119-22.
  • Kerkmeijer L, Wielsma S, Bekkers R, Pyman J, Tan J, Quinn M. Guidelines following
  • hydatidiform mole: a reappraisal. The Australian & New Zealand journal of obstetrics & gynaecology.
  • ;46(2):112-8.

KLİNİĞİMİZE BAŞVURAN MOL GEBELİK OLGULARININ RETROSPEKTİF İNCELENMESİ: 5 YILLIK KLİNİK DENEYİM

Year 2014, Volume: 5 Issue: 17, 18 - 23, 03.03.2015
https://doi.org/10.17944/mkutfd.18119

Abstract

Amaç: Bu çalışmada kliniğimizde molar gebelik
tanısıyla tedavi edilen hastaların verileri
kullanılarak gestasyonel trofoblastik hastalıkların
insidansını belirlemeyi amaçladık.
Gereç ve yöntem: Ocak 2009 ve Ocak 2014 yılları
arasında kliniğimizde molar gebelik tanısı almış
hastaların dosyaları retrospektif olarak incelendi.
Hastaların yaş, gravida, parite ve abortus bilgileri
kaydedildi. Olguların hikayesi, ultrasonografi
bulguları, β HCG ile birlikte laboratuar değerleri,
histopatoloji sonuçları, tedavi yöntemleri ve takipte
β HCG değerleri kayıt edildi.

Bulgular: Kliniğimizdeki molar gebelik insidansı
1000 doğumda 5 olarak bulundu. Hastaların
ortalama yaşı 28.72 ±7,5 olup ortalama gestasyonel
yaş 10±2,4 haftaydı. β HCG değerleri 240 ile
145100 arasında değişmekteydi. Hastaların
20’sinde (%33.3) ultrason bulgusu molar gebelik ile
uyumlu izlenmişti. Patoloji sonuçları 45 (%75)
hastada parsiyel mol, 12 (%20) hastada komplet
mol ve 3 (%5) hastada koryokarsinom gelmiştir.
Olgularda hastalık ve komplikasyonlarına ait ölüm
olgusuna rastlanmamıştır.
Sonuç: Kliniğimizde gestasyonel trofoblastik
hastalık insidansı 1000 doğumda 5 olup daha kesin
bir insidansa ulaşmak için ileri düzeyde araştırmalar
yapılması gerekmektedir.

References

  • Kohorn EI. Negotiating a staging and risk factor scoring system for gestational trophoblastic
  • neoplasia. A progress report. The Journal of reproductive medicine. 2002;47(6):445-50.
  • Berkowitz RS, Goldstein DP. Current management of gestational trophoblastic diseases.
  • Gynecologic oncology. 2009;112(3):654-62.
  • Davis JR, Surwit EA, Garay JP, Fortier KJ. Sex assignment in gestational trophoblastic
  • neoplasia. American journal of obstetrics and gynecology. 1984;148(6):722-5.
  • Surti U, Szulman AE, O'Brien S. Dispermic origin and clinical outcome of three complete
  • hydatidiform moles with 46,XY karyotype. American journal of obstetrics and gynecology.
  • ;144(1):84-7.
  • Hammond CB, Evans AC. Gestational trophoblastic disease. Current therapy in endocrinology
  • and metabolism. 1997;6:603-6.
  • Tham BW, Everard JE, Tidy JA, Drew D, Hancock BW. Gestational trophoblastic disease in
  • the Asian population of Northern England and North Wales. BJOG : an international journal of
  • obstetrics and gynaecology. 2003;110(6):555-9.
  • Lybol C, Centen DW, Thomas CM, ten Kate-Booij MJ, Verheijen RH, Sweep FC, et al. Fatal
  • cases of gestational trophoblastic neoplasia over four decades in the Netherlands: a retrospective
  • cohort study. BJOG : an international journal of obstetrics and gynaecology. 2012;119(12):1465-72.
  • Cakmak B, Toprak M, Nacar MC, Koseoglu RD, Guneri N. Incidence of gestational
  • trophoblastic disease in Tokat province, Turkey. Journal of the Turkish German Gynecological
  • Association. 2014;15(1):22-4.
  • Seckl MJ, Sebire NJ, Berkowitz RS. Gestational trophoblastic disease. Lancet.
  • ;376(9742):717-29.
  • Palmer JR. Advances in the epidemiology of gestational trophoblastic disease. The Journal of
  • reproductive medicine. 1994;39(3):155-62.
  • Therasakvichya S. Gestational trophoblastic disease in 2005. Journal of the Medical
  • Association of Thailand = Chotmaihet thangphaet. 2005;88 Suppl 2:S119-23.
  • Martin BH, Kim JH. Changes in gestational trophoblastic tumors over four decades. A Korean
  • experience. The Journal of reproductive medicine. 1998;43(1):60-8.
  • Hayashi K, Bracken MB, Freeman DH, Jr., Hellenbrand K. Hydatidiform mole in the United
  • States (1970-1977): a statistical and theoretical analysis. American journal of epidemiology.
  • ;115(1):67-77.
  • Sebire NJ, Foskett M, Fisher RA, Rees H, Seckl M, Newlands E. Risk of partial and complete
  • hydatidiform molar pregnancy in relation to maternal age. BJOG : an international journal of
  • obstetrics and gynaecology. 2002;109(1):99-102.
  • Sand PK, Lurain JR, Brewer JI. Repeat gestational trophoblastic disease. Obstetrics and
  • gynecology. 1984;63(2):140-4.
  • Tierney JP, Welsh J, Owen P. Management of early pregnancy loss--a complete audit cycle.
  • Journal of obstetrics and gynaecology : the journal of the Institute of Obstetrics and Gynaecology.
  • ;26(3):229-32.
  • Hou JL, Wan XR, Xiang Y, Qi QW, Yang XY. Changes of clinical features in hydatidiform
  • mole: analysis of 113 cases. The Journal of reproductive medicine. 2008;53(8):629-33.
  • Nayeri UA, West AB, Grossetta Nardini HK, Copel JA, Sfakianaki AK. Systematic review of
  • sonographic findings of placental mesenchymal dysplasia and subsequent pregnancy outcome.
  • Ultrasound in obstetrics & gynecology : the official journal of the International Society of Ultrasound
  • in Obstetrics and Gynecology. 2013;41(4):366-74.
  • Fowler DJ, Lindsay I, Seckl MJ, Sebire NJ. Routine pre-evacuation ultrasound diagnosis of
  • hydatidiform mole: experience of more than 1000 cases from a regional referral center. Ultrasound in obstetrics & gynecology : the official journal of the International Society of Ultrasound in Obstetrics
  • and Gynecology. 2006;27(1):56-60.
  • Sebire NJ, Rees H, Paradinas F, Seckl M, Newlands E. The diagnostic implications of routine
  • ultrasound examination in histologically confirmed early molar pregnancies. Ultrasound in obstetrics
  • & gynecology : the official journal of the International Society of Ultrasound in Obstetrics and
  • Gynecology. 2001;18(6):662-5.
  • Berkowitz RS. Gestational trophoblastic tumors and malignant ovarian germ cell tumors.
  • Current opinion in oncology. 1989;1(1):119-22.
  • Kerkmeijer L, Wielsma S, Bekkers R, Pyman J, Tan J, Quinn M. Guidelines following
  • hydatidiform mole: a reappraisal. The Australian & New Zealand journal of obstetrics & gynaecology.
  • ;46(2):112-8.
There are 57 citations in total.

Details

Primary Language Turkish
Subjects Health Care Administration
Journal Section Original Articles
Authors

Atilla Karateke This is me

Raziye Kurt This is me

Mehmet Dede This is me

Ayhan Gül This is me

Çetin Kılıç This is me

Defne Özkaya This is me

Publication Date March 3, 2015
Submission Date March 1, 2015
Published in Issue Year 2014 Volume: 5 Issue: 17

Cite

Vancouver Karateke A, Kurt R, Dede M, Gül A, Kılıç Ç, Özkaya D. KLİNİĞİMİZE BAŞVURAN MOL GEBELİK OLGULARININ RETROSPEKTİF İNCELENMESİ: 5 YILLIK KLİNİK DENEYİM. mkutfd. 2015;5(17):18-23.

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