Gestational Trophoblastic Diseases: A Review of the Clinical Presentation and Management at the Alex Ekwueme Federal University Teaching Hospital Abakaliki

Abstract

Background: Gestational trophoblastic diseases (GTD) are potentially curable with retention of reproductive function once the correct diagnosis is made and treatment is commenced early with adequate follow up. Objective: The objective of this study was to determine the incidence, clinical presentation, management and treatment outcomes of gestational trophoblastic diseases in a tertiary hospital in Abakaliki, Southeast Nigeria. Materials and Methods: This was a retrospective descriptive study of gestational trophoblastic diseases managed at Alex Ekwueme Federal University Teaching Hospital, Abakaliki (AEFUTHA) over a 6-year period. The statistical analysis was done using SPSS version 22. Results: The incidence of GTD was 4.6 per 1000 deliveries. Women who were less than 20 years and more than 40 years of age accounted for 5.9% and 23.5% of cases of GTD respectively. Women who were para 5 and above accounted for 76.5% of those who presented with GTD. All the patients presented with vaginal bleeding. Suction evacuation (76.5%) was the commonest form of treatment offered to women with GTD. The commonest complication was anaemia (94.1%). Maternal death due to GTD was 8.8%. Most (58.8%) of the patients did not turn up for follow-up. Conclusion: Gestational trophoblastic diseases has remained an important cause of maternal morbidity and mortality in our hospital due to poor compliance with follow-up. Call and recall system should be introduced in the management of patients with GTD to improve compliance to management standard.