Clinicopathological Study of Gestational Trophoblastic Diseases

Gestational Trophoblastic Diseases (GTD) are characterized by abnormal proliferation of different trophoblastic cells during placentation. Gestational Trophoblastic Diseases include complete mole, partial mole, invasive mole, placental site trophoblastic tumor and choriocarcinoma. The aim of the study is to determine the incidence of hydatidiform mole, invasive mole, persistent trophoblastic disease and choriocarcinoma and to evaluate the histomorphological features of Gestational Trophoblastic Diseases with light microscopy The study is conducted between three year period from October 2008 to September 2011. The total number of pregnancies encountered in the three years period was 34, 649. Total no of live births reported was 33794. A total of 13, 593 biopsies were received in the department of pathology, Thanjavur medical college during the period of 3years. Among these, 326 were gynecological neoplasms, The analysis of biopsies and hysterectomy specimens revealed 55 cases of hydatidiform mole, 1 case of invasive mole, 6 cases of choriocarcinoma and 1 case of persistent trophoblastic disease. The spectrum of gestational trophoblastic disease included in this study were hydatidiform mole 55 (87.3 %), invasive mole 1 (1.58 %), choriocarcinoma 6 (9.5 %). The incidence of gestational trophoblastic diseases is found to be 1 in 550 pregnancies. The incidence of hydatidiform mole is found to be 1 in 630 pregnancies, incidence of invasive mole is found to be 1 in 35714 pregnancies and the incidence of choriocarcinoma is found to be 1 in 5780 pregnancies. Hydatidiform mole was found to be highest in the age group of 21 30 years (70.9 %), whereas choriocarcinoma was widely distributed in the age group of 21 40 years. Hydatidiform mole were more common in the primi para followed by para 3 and para 2. Choriocarcinoma was found to have an equal occurrence in 2nd, 3rd and 4th parity. Complete mole constituted about 69.08 % of cases and partial mole constituted about 30.9 %cases. The incidence of gestational trophoblastic diseases was found to be 1 in 597 live births. Choriocarcinoma following an antecedent molar pregnancy and term pregnancy have an equal incidence.