Evaluation of cases diagnosed with gestational trophoblastic disease

Gestational Trophoblastic Disease (GTD) is a clinically and genetically broad spectrum disease in which trophoblasts proliferate abnormally. The aim of our study is to evaluate the incidence,demographic characteristics and possible complications of patients diagnosed with GTD in our clinic. Another aim is to present the follow-up and treatment approach of the patients in line with theinformation in the literature. 134 patients who applied to our clinic between January 2005 and December 2020 and whose pathological diagnosis was interpreted in favor of GTD were included in the study. Demographic data of patients such as age, gravida, parity, abortion and number of living, blood group, β-hCG, the number of term pregnancies after molar pregnancy, gestational week, hemoglobin values before and after the procedure, and thyroid function tests were examined. Conditions such as hyperemesis, hyperthyroidism and preeclampsia were determined. History of previous molar pregnancy, transfusion and chemotherapy requirements were recorded. The data of the patients were recorded by examining the hospital archive scans and electronic database. There were 11,498 births during the study period and Gestational Trophoblastic Disease (GTD) was diagnosed in 134 cases. The calculated incidence of GTD was 11,65/1000. The mean age of the patients who developed GTD was found to be 29,9±7,49. Patients were diagnosed in the eighth week on average. According to the pathology results of the patients, the number of patients diagnosed with partial mole was 91 (67.9%), and 37 patients (27.6%) diagnosed with complete mole. The number of patients whose diagnosis was hydatiform mole and whose subtype could not be determined was three (2.2%). Invasive mole was detected in one patient (0.7%), choriocarcinoma in one patient (0.7%) , and placental site trophoblastic tumor (PSTT) in one patient (0.7%). Considering the pathology results, two groups were formed and compared between those diagnosed with partial mole and complete hydatiform mole. No statistically significant difference was observed between TFT, hemoglobin values and β-hCG values. While hysterectomy was performed in two patients (1.49%), D&C/vacuum curettage/therapeutic curettage was performed in 132 patients (98.5%).β-hCG follow-up of the patients was performed at certain periods. Patients with persistence of β-hCG received single-agent chemotherapy (methotrexate). GTD was mostly seen in the A Rh(+) blood group, and the least in the B Rh(-) and AB Rh(-) groups (the rate was 0.7% for each). In the light of this information, detailed anamnesis of the patients and appropriate follow-up-treatment should be performed. Early diagnosis, treatment and follow-up are critical in preventing disease- related morbidity and mortality. The incidence of GTD, which has a high recovery rate with adequate treatment and follow-up, is variable and can be determined by regional and population-based studies. Follow-up of patients by experienced and specific centers may facilitate the follow-up and treatment of the disease. Keywords: Gestational trophoblastic disease, β-hCG, hydatiform mole, partial mole, complete mole