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Category: Volume 06 Issue 05 May 2018
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Title: Obstetric Outcome Following Vesicular Mole Evacuation in a Tertiary Care Centre

Authors: Dr Nandini VR, Dr Deepa M

 DOI:  https://dx.doi.org/10.18535/jmscr/v6i5.172

Abstract

Background: Gestational Trophoblastic Diseases (GTD) are a group of diseases in which the basic disorder lies in the abnormal development and growth of trophoblast. The success story of the GTD is the curability by chemotherapy ,mainly of tumours arising in the trophoblast ,the outlook of which used to be grave previously. The invasive nature of the trophoblast is self limited in normal gestation, thus differing in its essential nature from carcinoma. The mechanism of the aggressive growth pattern of the trophoblast and it'sself limitation is as poorly understood as is that of its malignant transformation.

Objectives of the study

  1. To study the incidence of abortion and repeat vesicular mole following vesicular mole evacuation.
  2. To study the fertility rate after vesicular mole evacuation and also following abortions after a vesicular mole.
  3. To study whether increased incidence of abortion and repeat vesicular mole after chemotherapy.
  4. To study whether increased incidence of congenital anomalies following vesicular mole evacuation.
  5. To study whether there is any decrease in term deliveries in women who were given chemotherapy.

Study Setting and Design: The design adopted is descriptive research design.118 pregnant women with history of previous vesicular mole, who attended the Trophoblastic clinic of Sree Avittam Thirunal Hospital, Thiruvananthapuram are allocated. Medical records were kept for each patients. These 118 patients had 146 pregnancies during the period of study and 18 patients are still continuing with pregnancy and all of them have completed their fifth month of pregnancy.

Results: Data collected was analysed with descriptive statistics in percentage.

Conclusion: The present study shows that the proportion of abortion in patients who conceived following previous history of vesicular mole is 10.3% which comes in the usual normal range for normal population .Only 2.7% of patients with abortion after vesicular mole had subsequent normal pregnancy. Proportion of abortions (18.2%) and repeat vesicular mole (13.6%) is increased in patients who were not allowed pregnancy following a vesicular mole. Proportion  of abortion(20%) and repeat vesicular mole(20%) is more after chemotherapy .Proportion  of term pregnancy is slightly less (60%) in patients who were given chemotherapy than in patients who were not given chemotherapy .No congenital anomalies and still births were reported in this study.

Keywords: Vesicular mole, Gestational Trophoblastic, Diseases, Obstetric outcome.

References

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Corresponding Author

Dr Deepa M

Asst. Professor, Dept of O and G, SAT hospital, Govt. Medical College, Trivandrum