Study of gestational trophoblastic diseases at a tertiary care hospital in India


  • Ramalingappa C. Antaratani Department of Obstetrics and Gynecology, KIMS, Hubli, Karnataka, India
  • Shruthi M. Department of Obstetrics and Gynecology, KIMS, Hubli, Karnataka, India



Gestational trophoblastic disease, Hydatidiform mole, Invasive mole


Background: Gestational trophoblastic disease refers to the heterogeneous group of interrelated lesions that arises from abnormal proliferation of placental trophoblasts. GTNs are among the rare human tumours that can be cured even in the presence of widespread dissemination. Although GTNs commonly follow a molar pregnancy, they can occur after any gestational event, including induced or spontaneous abortion, ectopic pregnancy, or term pregnancy. The study was conducted to know the incidence of different types of gestational trophoblastic diseases in the local population and the percentage of people ultimately requiring chemotherapy.

Methods: The retrospective analysis of case record of 124 women with a diagnosis of GTD admitted to Karnataka Institute of Medical Sciences Hubli between November 2008 to November 2017.

Results: A total of 124 cases of GTD were reviewed. Hydatidiform mole was diagnosed in 91 patients; of those experienced spontaneous remission after evacuation. 04 patients had persistent gestational trophoblastic Neoplasia and 13 cases of invasive mole (GTN) 1 case of epitheloid trophoblastic tumors and 15 cases of choriocarcinoma 99 (80%) had low-risk GTN, 25 (20%) had high-risk GTN.

Conclusions: Hydatidiform mole was found to be the most common form of gestational trophoblastic diseases. Majority of the cases got cured by simple surgical evacuation. During the course of our study some rare cases of gestational trophoblastic diseases were noted. Patients’ compliance for serial follow up is a highly challenging task in developing countries. Registration of women with GTD represents a minimum standard of care.


Kaji T. Ohama K. Androgenetic origin of Hydatidiform mole. 1997:268:633-4.

Czernobilsky B. Barash A, Lancet M. Partial moles a clinicopathological study of 25 cases. Obstet Gynecol. 1982:59:75-7.

Hui P. Gestational Trophoblastic Disease Diagnostic and Molecular Genetic Pathology, Dec 2011,1-179.

Sebire NJ, Fisher RA, Rees HC. Histopathological diagnosis of partial and complete hydatidiform mole in the first trimester of pregnancy. Pediat Develop Pathol. 2003 Jan 1;6(1):69-77.

Seckl MJ, Dhillon T, Dancey G, Foskett M, Paradinas FJ, Rees HC, et al. Increased gestational age at evacuation of a complete hydatidiform mole: does it correlate with increased risk of requiring chemotherapy?. J Reprod Med. 2004;49(7):527-30.

Khoo SK Siddhu M, Bartz D. Persistence and malignant squeal of gestational Trophoblastic disease, clinical presentation, diagnosis, treatment and outcome. Aust NZJ Obst Gynecol. 2010:50:81-6.

Newland SES, Holden L, Seckl M, Strickland S, Rustin G. Management of brain metastasis in patients with high risk gestational trophoblastic diseases Reprod Med. 2002;47:465-71

Ngan S, Seckl MJ. Gestational trophoblastic neoplasia management: an update. Current opinion in oncology. 2007 Sep 1;19(5):486-91.

Sebire NJ, Lindsay I. Current issues in histopathology of gestational trophoblastic tumour. 2010:29:30-4.

Leisorowitz GS, Webb MJ. Treatment of PSTT with hysterotomy, uterine Reconstruction Obstet Gynecol Oncol. 1996;8:696-9.

Tsuji Y, Tsubamohn H, Ogasawara T, Koyama K. Case of PSTT treated with chemotherapy followed by open uterine tumour resection to preserve ferility. Gynecol Oncol. 2002;87:303-7.

van Trommel NE, Massuger LF, Verheijen RH, Sweep FC, Thomas CM. The curative effect of a second curettage in persistent trophoblastic disease: a retrospective cohort survey. Gynecologic oncology. 2005 Oct 1;99(1):6-13.

Alazzam MI, Tidy J, Hancock BW, Osborne R. First line chemotherapy in low risk gestational trophoblastic neoplasia. Cochrane Database Syst Rev. 2009 Jan 1;1.

Stevens FT, Katzorke N, Tempfer C, Kreimer U, Bizjak GI, Fleisch MC, et al. Gestational trophoblastic disorders: an update in 2015. Geburtshilfe und Frauenheilkunde. 2015 Oct;75(10):1043.

Lurain JR. Gestational Trophoblastic Disease II Classification, Management of Gestational Trophoblastic Neoplasia. AMJ Obst Gynecol. 2011;204(1):11-8.

Sebire NJ, Seckl MJ. Gestational trophoblastic disease: current management of hydatidiform mole. Bmj. 2008 Aug 15;337:a1193.

Tidy J, Hancock BW. The management of gestational trophoblastic disease. Green-Top Guideline. 2010(38):1-1.






Original Research Articles