Gestational trophoblastic diseases: an observational study at a tertiary care teaching hospital in Jharkhand, India


  • Archana Kumari Department of Obstetrics and Gynecology, RIMS, Ranchi, Jharkhand, India
  • Nikita Chauhan Department of Obstetrics and Gynecology, RIMS, Ranchi, Jharkhand, India



Choriocarcinoma, Gestational trophoblastic neoplasia, Gestational trophoblastic disease, Hydatidiform mole, Invasive mole, Molar pregnancy


Background: Gestational Trophoblastic Diseases (GTD) encompass a wide spectrum of proliferative disorders of trophoblast tissue, which hold a good prognosis if diagnosed and treated on time. A close understanding of the disease spectrum is therefore needed to reduce morbidity and mortality.

Methods: This is an observational study (both prospective and retrospective analysis) conducted in Rajendra Institute of Medical Sciences, a tertiary care teaching hospital in Ranchi, Jharkhand over a period of 2 years from 1st January 2017 to 31st December 2018.

Results: A total of 162 cases of GTD were identified during the study period. Disease spectrum comprised of complete molar pregnancy in 146 (90.12%) and partial molar pregnancy in 7 (4.3%), GTN in 9 out of 162 cases (5.5%). Bleeding per vaginum preceded by amenorrhea was the most common symptom, observed in 95.4% of the cases. Uterine size was more than period of amenorrhea in almost 50% of the cases. Theca lutein cysts were found in 39.8% of the cases, hypertension in 21.5%, hyperthyroidism in 6.5% cases. Overall, there were nine (5.56%) cases of choriocarcinoma and six (3.7%) cases of Invasive mole. Remission rate in GTN was 86.7% with chemotherapy.

Conclusions: Women complaining of vaginal bleeding in first half of pregnancy with uterine size more than period of amenorrhea must be evaluated for GTD by ultrasound and serum beta HCG. For cases of molar pregnancies, suction and evacuation remains the treatment of choice but need for regular follow-up and strict compliance to contraception during entire follow up has to be emphasized. Cases of GTN have excellent remission with chemotherapy.


Altieri A, Franceschi S, Ferlay J, Smith J, Vecchia C. Epidemiology and aetiology of gestational trophoblastic diseases. Lancet Oncol. 2003;4:670-8.

Kolawole A, Nwajagu J, Oguntayo A, Zayyan M, Adewuyi S. Gestational trophoblastic disease in Abuth Zaria, Nigeria: a 5-year review. Trop J Obstet Gynaecol. 2016;33:209.

Jagtap SV, Aher V, Gadhiya S, Jagtap SS. Gestational trophoblastic disease - clinicopathological study at tertiary care hospital. J Clin Diagnos Res. 2017;11:EC27-EC30.

Bruce S, Sorosky J. Gestational trophoblastic disease. In: StatPearls. Treasure Island (FL): Stat Pearls Publishing; 2020. Available at: Accessed on 12th April 2020.

Nwabuobi C, Arlier S, Schatz F, Guzeloglu-Kayisli O, Lockwood CJ, Kayisli UA. hCG: biological functions and clinical applications. Int J Mol Sci. 2017;18(10):2037.

Agrawal N, Sagtani RA, Budhathoki SS, Pokhare HP. Clinicopathological profile of molar pregnancies in a tertiary care centre of Eastern Nepal: a retrospective review of medical records. Gynecol Oncol Res Pract. 2015;2:9-12.

Koirala A, Khatiwada P, Giri A, Kandel P, Regmi M, Upreti D. The demographics of molar pregnancies in BPKIHS. Kathmandu Univ Med J KUMJ. 2011;9(36):298-300.

Sekharan P, Shreedevi NS, Paily VP. Hydatidiform mole in Calicut, India. Proc XII World Congr Gestation Trophobla Dis Boston. 2003:11-12.

Aghajanian P. Gestational trophoblastic disease. In: Decherney AH, Nathan L, Godwin TM, Laufer N, editors. Current diagnosis treatment in obstetrics and gynecology. 10th Ed. New York: Mc Craw Hill Medical Publishing Division; 2007:885-895.

Agboola A. Trophoblastic tumours. Textbook of obstetrics and gynecology for medical students. 2 nd Ed. Ibadan, Nigeria: Heinemann Educational Books; 2006:218-224.

Sebire NJ, Foskett M, Fisher RA, Rees H, Seckl M, Newlands E. Risks of partial and complete hydatidiform molar pregnancy in relation to maternal age. BJOG. 2002;109:99-102.

Saraf S, Ghodke A. A study of gestational trophoblastic disease at a tertiary care centre. Indian J Res. 2016;5(2):230-1.

Brinton LA, Bracken MB, Connelly RR. Choriocarcinoma incidence in the United States. Am J Epidemiol. 1986;123(6):1094-100.

Fatima M, Kasi PM, Baloch SN, Kassi M, Marri SM, Kassi M, et al. Incidence, management and outcome of molar pregnancies at a tertiary care hospital in Quetta, Pakistan. International scholarly Research Network ISRN. 2011;2011:925316.

Walkington L, Webster J, Hancock BW, Everard J, Coleman RE. Hyperthyroidism and human chorionic gonadotrophin production in gestational trophoblastic disease. Br J Cancer. 2011;104:1665-9.

Singh N, Singh U, Srivastava S. Prospective and retrospective analysis of gestational trophoblastic disease over a period of 5 years. J South Asian Federation of Obst and Gynec. 2013;5(1):11-4.

Gueye M, Ndiaye-Gueye MD, Kane Gueye SM, Moreau JC. Fatal cases of gestational trophoblastic neoplasia in a National trophoblastic disease reference center in Dakar Senegal. Int J MCH AIDS. 2016;5(1):32-8.






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