EP403/#1097 Management and outcome of gestational trophoblastic disease in a tunisian public hospital. (4th December 2022)

• Record Type: Journal Article
• Authors: Ouederni, Meriem; Bettaieb, Hajer; Rouiss, Hadhami; Souayeh, Nesrine; Bouhmida, Rahma; Lamiri, Hadir; Chermiti, Amal; Mbarki, Wael; Oueslati, Hedhili; Mbarki, Chaouki
• Is Part Of: International journal of gynecological cancer. Volume 32(2022)Supplement 3
• Page Start: A217
• Page End: A217
• Publication Date: 2022-12-04
• Subjects: Generative organs, Female -- Cancer -- Periodicals; 616.99465
• DOI: 10.1136/ijgc-2022-igcs.492
• Languages: English
• ISSNs: 1048-891X

Abstract

Abstract : Objectives: Gestational trophoblastic disease (GTD) arises from abnormal placenta and is composed of a spectrum of premalignant to malignant disorders. The aim of this study was to analyze the current management modalities as well as the outcome of GTD. Methods: This study was carried out in the gynecology and obstetrics department of Ben Arous hospital over a period of 18 years extending from January 2004 to June 2021. We included all patients matching the FIGO diagnostic criteria or with a histological confirmation. Results: 204 cases of GTD were reported in our study divided as follows: 198 hydatidiform moles and 15 cases of gestational trophoblastic neoplasia (GTN). The mean age of patients was 33.86 years. 81% of molar pregnancies were diagnosed between 6 and 12 weeks' gestation. In 12.7% of patients, the initial diagnosis was that of an incomplete abortion or a miscarriage. These patients received Misoprostol: 57% of them had a subsequent aspiration for failure to evacuate. 82.3% of patients had an ultrasound-guided uterine evacuation straight away. Contraception was systematic in all patients. Clinical Follow-up, monitoring serum chorionic gonadotropin (βHCG) as well as ultrasounds were performed in 77.5% of the patients only. A positive outcome was observed in 144 patients while 9 patients had an unfavorable evolution defined either by stagnation or by re-ascension of the βHCG. Hysterectomy was performed in 3 cases. 9 patients had chemotherapy. Conclusions: GTN is a significant source of maternal morbidity with increased risk of mortality from complications if not detected early and treated promptly.