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A One-Year Epidemiological Perspective of Molar Pregnancies at Orotta Maternity Referral Hospital: Asmara, Eritrea

Received: 26 November 2022     Accepted: 5 January 2023     Published: 13 January 2023
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Abstract

Gestational trophoblastic diseases (GTD) are a group of diseases originating from the placenta, with significant morbidity and mortality, especially in developing countries. A one-year prospective study on GTD was done to determine the incidence of GTD identify the risk factors; explain the clinical presentation; describe the management; and record the outcomes at Orotta Maternity Referral Hospital (OMRH) Asmara, Eritrea; A protocol for the prospective study of GTD was prepared with involvement of colleagues. All collected data was reviewed and finalized by the author. Statistical analysis was done using Statistical Package for the Social Sciences (SPSS). During the study period a total of 6845 deliveries and 45 cases of GTD were recorded at OMRH. This gives an incidence of 6.6 per 1000 deliveries. Primgravid mothers were more affected. The majority of cases were complete molar pregnancy (87%) and vaginal bleeding was the main presentation. Pregnancy test result was read as negative in 7% of cases. Of the cases followed, 77.7% recovered while 11.1% required chemotherapy because of persistent disease and 8.9% were lost to follow up. The study confirms higher incidence, of GTD in Eritrea as compared to results of some African countries. The need to strengthen histological services and quantitative serum tests were identified as crucial in the effective management of GTD at OMRH. A standard and systematic approach of diagnosis, treatment and strict fellow-up of cases is required for better outcome.

Published in Science Journal of Public Health (Volume 11, Issue 1)
DOI 10.11648/j.sjph.20231101.14
Page(s) 17-21
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2023. Published by Science Publishing Group

Keywords

Gestational Trophoblastic Diseases, Complete Molar Pregnancy, Evacuation and/or Suction of the Uterus, Methotrexate

References
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[2] Vasava Amarpali Puransinh at el. Hydatidiform mole: A review of management outcomes in a tertiary hospital, Sir T hospital Bhavnagar. Volume 4, Issue 10; October: 2020; Page No. 05-06.
[3] SU Mbamara, NJA Obiechina, GU Eleje. Gestational trophoblastic disease in a tertiary hospital in Nnewi, southeast Nigeria. Niger Med J 2009; 50: 87-9.
[4] Dereje Negussie. The profile of Gestational Trophoblastic diseases in two teaching hospitals in Addis Ababa, Ethiopia. Ethiopian journal of health sciences 14 (4): 195-201 March 2008.
[5] Dan K. Kaye. Gestational trophoblastic disease following complete hydatidiform mole in Mulago Hospital, Kampala, Uganda. African Health Sciences 2002; 2 (2): 47-51.
[6] Savage PM, Sita-Lumsden A, Dickson S, Iyer R, Everard J, Coleman R, Fisher RA, Short D, Casalboni S, Catalano K, Seckl MJ. The relationship of maternal age to molar pregnancy incidence, risks for chemotherapy and subsequent pregnancy outcome. Journal of Obstetrics and Gynaecology. 2013 May 1; 33 (4): 406-11.
[7] Berkowitz RS, Im SS, Bernstein MR, Goldstein DP. Gestational trophoblastic disease. Subsequent pregnancy outcome, including repeat molar pregnancy. J Reprod Med. 1998 Jan; 43 (1): 81–6.
[8] Pang Y P, Rajesh H, Tan L K. Molar pregnancy with false negative urine hCG: the hook effect. Singapore Med J 2010; 51 (3): e58.
[9] Laurence A. Cole, Sarah A. Khanlian. The need for a quantitative urine hCG assay. Clinical Biochemistry 42 (2009) 676–683.
[10] Laurence A. Cole, Shohreh Shahabi. Utility of Commonly Used Commercial HCG Immunoassays in the Diagnosis and Management of Trophoblastic Diseases. Clinical Chemistry 47: 2. 308–315 (2001).
[11] J A Tidy, Gillespie AM, Bright N, Radstone CR, Coleman RE, Hancock BW. Gestational trophoblastic disease: a study of mode of evacuation and subsequent need for treatment with chemotherapy. Gynecol. Oncol. 2000 Sep; 78 (3 Pt 1): 309–12.
[12] John Tidy, BW Hancock. Management of Gestational Trophoblastic Disease. Royal college of obstetricians and gynecology, February 2010, No. 38.
[13] F. Khan, J. Everard, S. Ahmed Low-risk persistent gestational trophoblastic disease treated with low-dose methotrexate. British Journal of Cancer (2003) 89, 2197 – 2201.
[14] K D Bagshawe, S D Lawler. Gestational trophoblastic tumours following initial diagnosis of partial hydatidiform mole. Lancet 1990 May 5; 335 (8697): 1074-6.
[15] Sabien Wielsma, Linda Kerkmeijer. Persistent trophoblast disease following partial molar pregnancy. Aust N Z J Obstet Gynaecol. 2006 Apr; 46 (2): 119-23.
[16] R J Chen 1, S C Huang. Persistent gestational trophoblastic tumor with partial hydatidiform mole as the antecedent pregnancy. Br J Obstet Gynaecol. 1994 Apr; 101 (4): 330-4.
[17] Qiuyi Wang, Jing Fu. Prophylactic chemotherapy for hydatidiform mole to prevent gestational trophoblastic neoplasia. Cochrane Database Syst Rev. 2017Sep; 2017 (9): CD007289.
[18] Mandefro Yilma, Shimelis Fantu. Magnitude of GTD at Hawassa University Hospital, Ethiopia: a five year retrospective analysis: Ethiopian Journal of Reproductive Health (EJRH) April, 2020, Volume 12, No. 2.
[19] Ahmed Zakaria, Reda Hemida, Waleed Elrefaie, Ehsan Refaie. Incidence and outcome of gestational trophoblastic disease in lower Egypt. African Health Sciences Vol 20 Issue 1, March, 2020.
[20] Giampiero Capobianco, Elettra Tinacci. High incidence of Gestational trophoblastic disease in a third level university Hospital, Italy: a retrospective cohort study. Frontiers in oncology. May 20, 2021.
[21] Amin O. Igwegbe. Hydatidiform Mole: A Review of Management Outcomes in a Tertiary Hospital in South East Nigeria. Annals of Medical and Health Sciences Research, April 2013-3 (2): 210-214.
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  • APA Style

    Dawit Estifanos, Dawit Sereke, Ogbaselassie Gebreamlak, Andebirhan Tewolde, Lidya Isack. (2023). A One-Year Epidemiological Perspective of Molar Pregnancies at Orotta Maternity Referral Hospital: Asmara, Eritrea. Science Journal of Public Health, 11(1), 17-21. https://doi.org/10.11648/j.sjph.20231101.14

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    ACS Style

    Dawit Estifanos; Dawit Sereke; Ogbaselassie Gebreamlak; Andebirhan Tewolde; Lidya Isack. A One-Year Epidemiological Perspective of Molar Pregnancies at Orotta Maternity Referral Hospital: Asmara, Eritrea. Sci. J. Public Health 2023, 11(1), 17-21. doi: 10.11648/j.sjph.20231101.14

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    AMA Style

    Dawit Estifanos, Dawit Sereke, Ogbaselassie Gebreamlak, Andebirhan Tewolde, Lidya Isack. A One-Year Epidemiological Perspective of Molar Pregnancies at Orotta Maternity Referral Hospital: Asmara, Eritrea. Sci J Public Health. 2023;11(1):17-21. doi: 10.11648/j.sjph.20231101.14

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  • @article{10.11648/j.sjph.20231101.14,
      author = {Dawit Estifanos and Dawit Sereke and Ogbaselassie Gebreamlak and Andebirhan Tewolde and Lidya Isack},
      title = {A One-Year Epidemiological Perspective of Molar Pregnancies at Orotta Maternity Referral Hospital: Asmara, Eritrea},
      journal = {Science Journal of Public Health},
      volume = {11},
      number = {1},
      pages = {17-21},
      doi = {10.11648/j.sjph.20231101.14},
      url = {https://doi.org/10.11648/j.sjph.20231101.14},
      eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.sjph.20231101.14},
      abstract = {Gestational trophoblastic diseases (GTD) are a group of diseases originating from the placenta, with significant morbidity and mortality, especially in developing countries. A one-year prospective study on GTD was done to determine the incidence of GTD identify the risk factors; explain the clinical presentation; describe the management; and record the outcomes at Orotta Maternity Referral Hospital (OMRH) Asmara, Eritrea; A protocol for the prospective study of GTD was prepared with involvement of colleagues. All collected data was reviewed and finalized by the author. Statistical analysis was done using Statistical Package for the Social Sciences (SPSS). During the study period a total of 6845 deliveries and 45 cases of GTD were recorded at OMRH. This gives an incidence of 6.6 per 1000 deliveries. Primgravid mothers were more affected. The majority of cases were complete molar pregnancy (87%) and vaginal bleeding was the main presentation. Pregnancy test result was read as negative in 7% of cases. Of the cases followed, 77.7% recovered while 11.1% required chemotherapy because of persistent disease and 8.9% were lost to follow up. The study confirms higher incidence, of GTD in Eritrea as compared to results of some African countries. The need to strengthen histological services and quantitative serum tests were identified as crucial in the effective management of GTD at OMRH. A standard and systematic approach of diagnosis, treatment and strict fellow-up of cases is required for better outcome.},
     year = {2023}
    }
    

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  • TY  - JOUR
    T1  - A One-Year Epidemiological Perspective of Molar Pregnancies at Orotta Maternity Referral Hospital: Asmara, Eritrea
    AU  - Dawit Estifanos
    AU  - Dawit Sereke
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    JO  - Science Journal of Public Health
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    PB  - Science Publishing Group
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    UR  - https://doi.org/10.11648/j.sjph.20231101.14
    AB  - Gestational trophoblastic diseases (GTD) are a group of diseases originating from the placenta, with significant morbidity and mortality, especially in developing countries. A one-year prospective study on GTD was done to determine the incidence of GTD identify the risk factors; explain the clinical presentation; describe the management; and record the outcomes at Orotta Maternity Referral Hospital (OMRH) Asmara, Eritrea; A protocol for the prospective study of GTD was prepared with involvement of colleagues. All collected data was reviewed and finalized by the author. Statistical analysis was done using Statistical Package for the Social Sciences (SPSS). During the study period a total of 6845 deliveries and 45 cases of GTD were recorded at OMRH. This gives an incidence of 6.6 per 1000 deliveries. Primgravid mothers were more affected. The majority of cases were complete molar pregnancy (87%) and vaginal bleeding was the main presentation. Pregnancy test result was read as negative in 7% of cases. Of the cases followed, 77.7% recovered while 11.1% required chemotherapy because of persistent disease and 8.9% were lost to follow up. The study confirms higher incidence, of GTD in Eritrea as compared to results of some African countries. The need to strengthen histological services and quantitative serum tests were identified as crucial in the effective management of GTD at OMRH. A standard and systematic approach of diagnosis, treatment and strict fellow-up of cases is required for better outcome.
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Author Information
  • Department of Obstetrics and Gynecology, Ministry of Health (MOH), Asmara, Eritrea

  • Department of Obstetrics and Gynecology, Mendefera Zonal Referral Hospital, Mendefera, Eritrea

  • Ministry of Health, Asmara, Eritrea

  • Ministry of Health, Asmara, Eritrea

  • Department of Obstetrics and Gynecology, Ministry of Health (MOH), Asmara, Eritrea

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