Clinical presentation and treatment outcome of molar pregnancy: Ten years experience at a Tertiary Care Hospital in Dammam, Saudi Arabia

Abstract

Objectives:To study the clinical presentation and treatment outcome of molar pregnancy at a Tertiary Care Hospital in Dammam, Saudi Arabia.Materials and Methods:Reviewed medical records of all molar pregnancy cases among all the deliveries at a tertiary care hospital in Dammam from 2005 to 2014, after approval by institutional ethical review committee. Data abstracted included patient's age, parity, presenting symptoms, gestational age at diagnosis, uterine size, ultrasonographic findings, BhCG level at the time of diagnosis and at follow-up after evacuation, and blood loss during evacuation. Data was entered and analyzed using Excel; frequency distribution for categorical variables and descriptive statistics for continuous variables were computed.Results:Of a total of 25,000 deliveries in ten years, 22 cases of complete molar pregnancy were encountered: 0.9 cases of molar pregnancy per 1000 pregnancies. Majority of patients (63.7%) were older than 35 years, and were nulliparous (45.5%). The commonest symptom was vaginal bleeding (86.4%) followed by hyperemesis gravidarum (41.0%); Hyperthyroidism was seen in 1 patient (4.5%). Ovarian enlargement by theca-lutin cyst was seen in 3 patients (13.6%). The majority of patients (63.6%) had normal BhCG within 9 weeks (63 days) after suction curettage. The majority of the cases followed a benign course.Conclusion:Aged older than 35 years seems a risk factor and vaginal bleeding is the commonest presenting symptom. Early booking of pregnant women to antenatal care clinics and routine first trimester ultrasound made diagnosis easier and earlier before complications appear.

Pathological features of early pregnancy disorders in women living at high altitude in KSA

“…A total of 57% of cases were observed in younger women, in agreement with findings from previous studies reporting that extremes of maternal ages (below 20 years or above 40 years) are associated with greater risk of molar pregnancy. 26 , 27 Nonetheless, we observed a higher incidence rate than that of another study in our country at sea level area, which has reported a rate of 0.09%. Although the incidence of gestational trophoblastic diseases has declined with the rapid socio-medical development of the KSA, this study indicated a higher percentage of molar pregnancies than those observed in other studies in high-altitude areas.…”

“… 25 Molar pregnancy is uncommon in our region. 26 The rate of molar pregnancy in this study was 6.26% of the total miscarriage cases, with an incidence of 0.4%. A total of 57% of cases were observed in younger women, in agreement with findings from previous studies reporting that extremes of maternal ages (below 20 years or above 40 years) are associated with greater risk of molar pregnancy.…”

Frequency of Molar Pregnancy in Abortion Cases Diagnosed by Histopathology Specimens at Nishtar Medical University Hospital, Multan Pakistan

“…Exact identification about the complete or partial hydatidiform moles is essential at these pregnancies may expose affected cases to persistent gestational trophoblastic disease like invasive mole, choriocarcinoma or placental site trophoblastic tumor. 10,11 In this study, the frequency of molar pregnancy among cases of abortion before 22 weeks of gestation was noted to be 2.1%. Reports about the incidence of molar pregnancy show variation as per specific regions.…”

Thyroid Function in Molar Pregnancies

“…Among the women with molar pregnancy enrolled and evaluated with thyroid function test, hyperthyroidism was present in 6 (10%) cases, which is comparable to the study done by Al-Talib AA , were hyperthyroidism was seen in 4.5% of molar pregnancies. 9 In a study by Lakra et al, hyperthyroidism was seen in 4(10.5%). 10 Another study done by Solo et al on a cohort study done on 60 cases of molar pregnancy reported prevalence of Hyperthyroidism as 13.3%, similar to our study.…”