Gestational Trophoblastic Disease in Ayder Comprehensive Specialized Hospital, Mekelle City, Northern Ethiopia: A Five Year Review Study

Abstract

Background: When the regulatory mechanisms fail, gestational trophoblastic diseases result in tumors that are highly invasive, metastatic, and very vascular. Virtually all malignant gestational trophoblastic disease is curable if detected early and treated promptly and aggressively.
Objective: To review the experiences with gestational trophoblastic disease at Ayder Comprehensive Specialized Hospital, Mekelle City, Northern Ethiopia, over a five year period.
Methods: A chart review was carried out on cases of Gestational trophoblastic disease seen at Ayder Comprehensive Specialized Hospital, Northern Ethiopia, between January 1, 2009 and December 31, 2013.
Results: Forty-five cases of gestational trophoblastic diseases were identified over the study period. Over the five-year period, there were 5,185 deliveries at Ayder Comprehensive Specialized Hospital, giving a ratio of 1 case of gestational trophoblastic disease for every 115 deliveries (equivalent to 868 cases per 100,000 deliveries). Numerous deficiencies in the clinical care of these patients were documented. Review of hospital charts revealed that patient histories were often incomplete, laboratory investigations were not obtained in a systematic fashion, specimens for pathological evaluation were not routinely sent, follow-up was poor and generally inadequate, and documentation of findings in the chart was often inexplicably incomplete.
Conclusion: The incidence of gestational trophoblastic disease appears to be extraordinarily high in northern Ethiopia. This study revealed numerous deficiencies in clinical practice which have prompted us to create a regional trophoblastic disease center in Mekelle to coordinate care throughout the region.