Gestational trophoblastic disease encompasses several entities like complete mole, partial mole, invasive mole, gestational trophoblastic carcinoma and trophoblastic carcinoma from implantation site. These entities are different from each other by their origin, morphology, their evolution and their treatment. Among all components, partial mole is very common (90%) and triploid genetically. This is one of the important causative factors of miscarriages. Very rarely (2-4%) partial mole can develop into invasive one presenting with features of incomplete abortion, missed abortion and sometimes as obstetric emergencies like intraperitoneal hemorrhage and torrential vaginal bleeding. So, proper diagnosis and timely intervention can prevent mortality and reduce morbidity of the patients. Here we report two such cases of partial invasive molar pregnancies with varied picture.
Background: Gestational trophoblastic disease (GTD) is a group of rare tumors that involve abnormal growth of cells inside a woman's uterus. GTD does not develop from cells of the uterus like cervical cancer or endometrial (uterine lining) cancer do. Instead, these tumors start in the cells that would normally develop into the placenta during pregnancy. GTD is unique because the maternal lesions arise from the fetal tissue as a molar pregnancy. All forms of GTD can be treated. In most cases the treatment produces a complete cure. The study was conducted to assess the various presenting features of GTD and factors associated with it.Methods: It was an observational hospital based prospective epidemiological study. Complete enumeration technique was followed and a total of 305 female patients were included in the sample. A pre-designed and pre-tested interview schedule was used to record different information and detailed history.Results: Of the 305 patients studied, 67.2% were diagnosed with H. mole, 23% patients were diagnosed with gestational trophoblastic tumor, among them 4.9% had choriocarcinoma. Majority were primigravida and of blood group O type. Pregnancy outcome after successful management of GTD were 63.3% had full term pregnancy, 20% cases had repeat molar pregnancy, 10% had spontaneous abortion while 6.7% (2/30) had pre term delivery.Conclusions: Gestational trophoblastic disease is seen most commonly in reproductive age group. If it is not diagnosed on time it can be fatal. This is a highly curable tumor even in the presence of distant metastasis.
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