Various presentations of gestational trophoblastic disease and its outcomes in a tertiary hospital

Background: Gestational trophoblastic disease encompasses a heterogeneous group of lesions arising from abnormal placental trophoblast proliferation. While molar pregnancy is the most common form, gestational trophoblastic neoplasia, though rare and often curable even with widespread dissemination, can follow any gestational event, including abortion, ectopic pregnancy, or term pregnancy. The aim of the study was to evaluate the various presentations and outcomes of gestational trophoblastic disease (GTD) in a tertiary hospital setting. Methods: This retrospective study, conducted in the department of gynecological oncology at BSMMU from June 2023 to July 2024, included 173 patients with GTD. Diagnoses were confirmed using ultrasonography, serum beta-hCG, and histopathology. Data were retrospectively collected from medical records, documenting key demographic and clinical information. Ethical approval and informed consent were obtained. Data analysis was performed using SPSS version 22. Results: Most participants were between 25-34 years (91.91%). The majority of GTD cases (54.91%) occurred in the 20-25 years age group, with bleeding per vagina being the most common clinical presentation (91.91%). Histopathology classified 72.83% of cases as complete moles. Treatment resulted in complete resolution for 85.55% of cases. Pre-evacuation beta hCG levels were above 100,000 IU/l in 72.83% of cases. Conclusions: This study highlights the diverse presentations and favorable outcomes of gestational trophoblastic disease (GTD) in a tertiary hospital, emphasizing the importance of tailored management and monitoring strategies.