Clinicopathological Study Of Gestational Trophoblastic Disease (GTD) In A Tertiary Care Hospital

Abstract

Background: Gestational trophoblastic disease (GTD) comprises a spectrum of disorders arising from abnormal trophoblastic proliferation, ranging from benign hydatidiform moles to malignant neoplasms such as choriocarcinoma. Early diagnosis and appropriate treatment are essential to ensure favorable outcomes and preserve fertility. Aim of the study: The aim of this study was to evaluate the clinicopathological characteristics, treatment modalities, and follow-up outcomes of patients diagnosed with GTD in a tertiary care hospital. Methods: This prospective observational study was conducted over one year in the Department of Obstetrics and Gynecology at a tertiary care hospital in Bangladesh. A total of 72 histopathologically confirmed GTD cases were enrolled based on set inclusion and exclusion criteria. Data on clinical features, serum β-hCG levels, histological subtypes, treatment, and outcomes were recorded. Statistical analysis was performed using SPSS version 26. Continuous variables were expressed as mean ± SD, categorical data as frequencies and percentages. A p-value ≤ 0.05 was considered statistically significant. Result: The majority of patients were aged 21–30 years (63.89%), with 84.72% presenting at ≤20 weeks of gestation. Complete mole was the most common subtype (83.33%), followed by partial mole and invasive mole (6.94% each), and choriocarcinoma (2.78%). Common symptoms included amenorrhea (100%), per vaginal bleeding (91.67%), and abdominal pain (40.28%). Mean β-hCG was 365,000 ± 130,000 mIU/mL. Half of the complete mole cases were successfully treated with suction and evacuation alone. β-hCG normalized within 8 weeks in 72.22% of patients, while 27.78% developed persistent GTD. No mortality was observed; 97.22% remained disease-free at one year. Conclusion: Complete mole remains the predominant GTD subtype, with early gestational presentation and elevated β-hCG levels aiding diagnosis. Timely management tailored to the disease subtype, combined with regular follow-up, ensures excellent prognosis with high survival and low recurrence.