Frequency of Common Clinical Presentation in patients with Molar Pregnancy in Gomal Medical College, Dera Ismail Khan, Pakistan

Authors

  • Najma Bibi, Irum Batool Hashmi, Sobia Ahmad, Neelam Mehsood, Naseem Saba, Shazia Bibi

DOI:

https://doi.org/10.53350/pjmhs020231711566

Keywords:

Molar Pregnancy, Abnormal vaginal bleeding, Hyperemesis, Theca Lutein cysts, Hyperthyroidism

Abstract

Introduction: Hydatidiform mole, frequently referred to as molar pregnancy, represents the most prevalent and benign variant of gestational trophoblastic disease. The occurrence rate of molar pregnancy exhibits significant geographical variability, ranging from one in every one hundred and fifty live births in Southeast Asia to one in every one thousand and five hundred pregnancies in the United States. This study identifies the most commonly presenting clinical features of molar pregnancy. The results will help clinicians in early diagnosing of molar pregnancy and prompt management.

Material and Method: The study was carried out in the Obstetrics and Gynecology Unit at MTI Gomal, located in DI Khan. The timeframe allocated for this study spanned one year, commencing on the 14th of June 2022 and concluding on the 13th of December 2022. Sample Size was 139 patients that were diagnosed and managed as cases of Molar pregnancy. Sampling Technique was convenience sampling or Non probability purposive and study design was descriptive study

Results: Within the scope of this research, a total of 139 patients diagnosed with molar pregnancy were meticulously observed in the obstetrics and gynecology department. Various clinical outcomes were identified and followed and hence put to further management. In these 139 patients the age range was from 18-48 years. It was found that the majority of the patients were complete moles. Abnormal vaginal bleeding emerged as the predominant clinical manifestation of molar pregnancy, being documented in 62 (44.6%) of the patients evaluated.

Conclusion: Targeting these various clinical outcomes and close surveillance will then help in

improving mortality and morbidity from molar disease.

Keywords: Molar Pregnancy, Abnormal vaginal bleeding, Hyperemesis, Theca Lutein cysts, Hyperthyroidism.

References

Yamada Y, Ohira S, Yamazaki T, Shiozawa T. Ectopic molar

pregnancy: Diagnostic efficacy of magnetic resonance imaging and

review of the literature. Case reports. Obstet Gynecol. 2016 Aug

;2016.

Singh Y, Singh LS, Singh LR, Liyak P, Vaz A. A study of molar

pregnancy at a tertiary center of India. Iosr. J Med Sci. 2016;15(9):49-

Eysbouts YK, Bulten J, Ottevanger PB, Thomas CM, Ten Kate-Booij

MJ, Van Herwaarden AE, Siebers AG, Sweep FC, Massuger LF.

Trends in incidence for gestational trophoblastic disease over the last

years in a population-based study.Gynecologiconcol. 2016 Jan

;140(1):70-5.

Moussa B, Azize DA, Goumbri LO. Molar Ectopic Pregnancy: A Case

Study from the Maternity Unit of the Bobo-Dioulasso Teaching

Hospital. Open J Obstet Gynecol. 2016 Dec 6;6(13):846-50.

Elias KM, Berkowitz RS, Horowitz NS. State-of-the-Art workup and

initial management of newly diagnosed molar pregnancy and

postmolar gestational trophoblastic neoplasia. J National

Comprehensive Cancer Network. 2019 Nov 1;17(11):1396-401.

Al-Talib AA. Clinical presentation and treatment outcome of molar

pregnancy: Ten years’ experience at a Tertiary Care Hospital in

Dammam, Saudi Arabia. J fam community Med. 2016 Sep;23(3):161.

Sinha K, Das R, Adhikari H. Thyroid Function in Molar Pregnancies.

JNGMC 2021 July; 19(1)22-5

Savage JL, Maturen KE, Mowers EL, Pasque KB, Wasnik AP, Dalton

VK, Bell JD. Sonographic diagnosis of partial versus complete molar

pregnancy: A reappraisal. J Clin Ultrasound. 2017 Feb;45(2):72-8.

Singh Y, Singh LS, Singh LR, Liyak P, Vaz A. A study of molar

pregnancy at tertiary centre of India. Iosr. J Med Sci. 2016;15(9):49-

Rahamni M, Parviz S. A case report of partial molar pregnancy

associated with a normal appearing dizygotic fetus. Asian Pacific

Journal of Reproduction. 2016 Apr 1;5(2):171-3.

Aiob A, Naskovica K, Amdur Zilberfarb I, Sharon A, Bornstein J,

Lowenstein L. Changes in diagnostic sensitivity, incidence andpresentation of complete and partial hydatidiform mole over the

years. Eur J ObstetGynecolReprod Biol. 2022; 274:136-41

Felemban AA, Bakri YN, Alkharif HA, Altuwaijri SM, Shalhoub J,

Berkowitz RS. Complete molar pregnancy. Clinical trends at King

Fahad Hospital, Riyadh, Kingdom of Saudi Arabia. J Reprod Med.

; 43:11-3.

Karimi-Zarchi M, Mortazavizadeh MR, Soltani-Gerdefaramrzi M,

Rouhi M, Yazdian-Anari P, Ahmadiyeh MH. Investigation of risk

factors, stage and outcome in patients with gestational trophoblastic

disease since 2001 to 2011 in Iran-Yazd. Int J Biomed Sci. 2015;

:166-72.

Martin BH, Kim JH. Changes in gestational trophoblastic tumors over

four decades. A Korean experience. J Reprod Med. 1998; 43:60-8.

Agrawal N, Sagtani RA, Budhathoki SS, Pokharel HP: Clinicoepidemiological

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.

Coullin P, Diatta AL, Boufettal H, Feingold J, Leguern E, Candelier

JJ: The involvement of the transgenerational effect in the high

incidence of the hydatidiform mole in Africa. Placenta. 2015; 36:48-

Sun SY, Melamed A, Goldstein DP, Bernstein MR, Horowitz NS,

Moron AF, et al. Changing presentation of complete hydatidiform

mole at the New England Trophoblastic Disease Center over the past

three decades: Does early diagnosis alter risk for gestational

trophoblastic neoplasia? Gynecol Oncol 2015; 138:46‑9.

Osathanondh R, Berkowitz RS,deCholnoky C, Smith BS Goldstein

DP,TysonJE.Hormonal measurement in patients with theca leutic

cysts and gestational trophoblastic diseases.JRepord

Med.1986;31(3):179-82.

Sadiq S, Panjwani S. Gestational trophoblastic disease experience at

the basic medical sciences institute, JPMC, Karachi. Pak J Med Sci.

; 22:483–5.

Moodley M, Tunkyl K, Moodley J. Gestational Trophoblastic

syndrome: an audit of 112 patients. A South African Experience. Int J

Gynecol Cancer. 2003;13(2):234–9

Ho PC,Wong LC and Ma HK. Plasma Prolactin, progesterone,

Estradiol and human chorionic gonadotrophin complete and partial

moles before and after evacuation. AmJ.Obstet.Gynecol,

;67(1):99-106.

Gestational trophoblastic tumors. Seminars in surgical Oncology.

; 6:347-53.

Berowitz RS, Golstein DP and Bernstein MR. Natural history of

Partial molar pregnancy. Obstetrics and Gynecology. Mole. Journal of

Reproductive medicine.2004; 66: 67-81.

Soto-Wright V, Bernstein M, Goldstein DP, Berkowitz RS: The

changing clinical presentation of complete molar pregnancy. Obstet

Gynecol. 1995; 86:775-9.

Mangili G, Garavaglia E, Cavoretto P, Gentile C, Scarfone G,

Rabaiotti E: Clinical presentation of hydatidiform mole in northern

Italy: has it changed in the last 20 years? Am J Obstet Gynecol.

; 198:302. e1-4.

Gaffield ME, Kapp N, Curtis KM. Combined oral contraceptive and

intrauterine device use among women with gestational trophoblastic

disease. Contraception 2009; 80:363‑71.

Bakhtiyari M, Mirzamoradi M, Kimyaiee P, Aghaie A, Mansournia MA,

Ashrafi‑Vand S, et al. Postmolar gestational trophoblastic

neoplasia:Beyond the traditional risk factors. Fertil Steril2015;

:649‑54.

Savage PM, Sita‑Lumsden A, Dickson S, Iyer R, Everard J, Coleman

R, et al. The relationship of maternal age to molar pregnancy

incidence, risks for chemotherapy and subsequent pregnancy

outcome. J ObstetGynaecol. 2013; 33:406‑11

Downloads

Crossmark - Check for Updates

How to Cite

Najma Bibi, Irum Batool Hashmi, Sobia Ahmad, Neelam Mehsood, Naseem Saba, Shazia Bibi. (2023). Frequency of Common Clinical Presentation in patients with Molar Pregnancy in Gomal Medical College, Dera Ismail Khan, Pakistan. Pakistan Journal of Medical & Health Sciences, 17(11), 566. https://doi.org/10.53350/pjmhs020231711566