Gestational trophoblastic disease and associated factors among women experiencing first trimester pregnancy loss at a regional referral hospital in central Tanzania: a cross-sectional study

Abstract

Background Gestational trophoblastic diseases (GTDs) may follow any form of pregnancy or a pregnancy loss. Early detection of GTDs is important, as some benign forms of the disease may progress into a chemoresistant and metastatic disease. This study aimed at determining the frequency of GTDs among women experiencing first trimester pregnancy loss and the associated patients’ characteristics. Methods This was a cross-sectional study that included 200 conveniently sampled women who experienced first trimester pregnancy loss from January to December 2019 at a Regional Referral Hospital in central Tanzania. The specimen obtained from products of conception were collected, formalin-fixed and paraffin-embedded and submitted for histopathological evaluation, for which haematoxylin and eosin stain was used. Data were analysed using SPSS version 23.0. The χ2 test was used to determine the association between categorical variables. p-Values ˂0.05 were considered statistically significant. Results Among 200 study participants, the overall frequency of GTDs was 42 (21%). Among those with GTDs, the most common histopathological diagnosis was partial hydatidiform mole (18 [42.9%]), followed by complete hydatidiform mole (17 [40.5%]) and choriocarcinoma (7 [16.5%]). In the studied participants, only increased human chorionic gonadotropin hormone levels were found to be statistically significantly associated with GTDs (p=0.000). Conclusions Results from this study suggest that routine histopathological evaluation of the products of conception is recommended in order to allow early detection of GTDs, including choriocarcinoma, which usually carries a poor prognosis. The histopathological reporting of choriocarcinoma among first trimester products of conception from Tanzania is novel.

Ten-Year Review of Gestational Trophoblastic Disease at Lady Reading Hospital, Peshawar

“…We observed that patients with low parity (i.e., nullipara 15.3%, para-one 17.6% and para two 17.0%) were the major group with GTD. Similar results were found in a regional study at Abbottabad (42% para 0-1) [16], a study in Tanzania 65% of patients were para 0-1 and studies by Fatima et al, Parazzini F et al, Brinton et al, and Saraf and Ghodke, which shows that risk of GTD decreases with increase in parity [9,[20][21][22][23].…”

“…In this study 80.16% of patients with GTD had RH positive antigen. Jagtap et al [15] reported similar findings (83.11%) and overall blood groups B (33.4%) and O (26.9%) were the most common blood groups in our study, while in a study in Karachi [11] blood group A was reported to be more prevalent (OR=1.6, CI=I.01-2.53); however, international studies found blood group O to be more prevalent (97.8% and 79.3%) [19][20]. In this study blood group, O was found more commonly in the malignant form of disease only.…”

The prevalence of molar pregnancy among patients with incomplete miscarriage at a maternity teaching hospital

“…This fits with what other studies in Oman, Tanzania, and Egypt found: there was no link between the number of pregnancies, having had a miscarriage before, or blood group and the number of GTDs and their types. [20][21][22] Al Riyami et al ( 2019) also reported no statistical association between GTD and multiparous women, although GTD was observed more in multiparous women. 21 In contrast, Lurain (2010) reported that a history of spontaneous abortion is a reported risk factor for molar pregnancies (both complete and partial).…”

“…Similarly, another study also reported that the partial hydatidiform mole was the most common (around 43%) histopathological finding. 20 In addition, Riyamiet al (2019) likewise found that around 55% of the sample was diagnosed with partial hydatidiform mole and approximately 44% of the sample was diagnosed with complete hydatidiform mole. 21…”

“…11 On the contrary, blood group O was observed to be the most common blood group type among participants in another study. 20 The incidence reported about GTD generally varies globally, and with regard to the KRI, there is no sufficient data about the incidence of GTD and its consequences. Therefore, this study aimed to identify the prevalence of GTD and its types among a cohort of Kurdish patients.…”