Survey on risk Factors and clinical symptoms of hydatiform-mole in pregnant women referred to Ayatollah Rouhani hospital in Babol: 2011-2017

Document Type : Original Article

Authors

1 Clinical Research Development Unit of Ayatollah Rouhani Hospital, Babol University of Medical Sciences, Babol, Iran. Assistant Professor, Department of Pathology, Faculty of Medicine , Babol University of Medical Sciences, Babol, Iran.

2 Medical Student, Student Research Committee, Faculty of Medicine, Babol University of Medical Sciences, Babol, Iran.

3 Clinical Research Development Unit of Ayatollah Rouhani Hospital, Babol University of Medical Sciences, Babol, Iran.

4 Infertility and Reproductive Health Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran. Professor, Department of Obstetrics and Gynecology, Faculty of Medicine, Babol University of Medical

Abstract

Introduction: Molar pregnancy is a type of abnormal pregnancy which is divided into complete and partial hydatiform mole. Its incidence varies in different countries and in different regions in every country. Its incidence is higher in Asia than elsewhere in the world, whereas occasionally its risk factors and clinical symptoms are different in various regions. Therefore, this study was performed with aim to evaluate the risk factors and clinical symptoms of hydatiform-mole in pregnant women referred to Ayatollah Rouhani hospital in Babol.
Methods: This retrospective descriptive study was performed on all pregnant women of hydatiforme mole with histopathologic definite diagnosis referred to the educational-therapeutic center of Ayatollah Rouhani Hospital in Babol from 2011-2017. Patients' information including demographic and clinical profiles was provided in a checklist format. Data were analyzed by SPSS software (version 18) and Chi-square and one-way ANOVA tests. P<0.05 was considered statistically significant.
Results: In this study during 2011-2017, there were 19145 pregnancies in Babol Rouhani hospital. According to the pathology report, 70 cases of molar pregnancy were recorded. There were 41 (58.6%) of partial hydatidiform mole and 28 (40%) of complete hydatidiform mole. Most patients with molar pregnancy were in the age range of 20-35 years. 31 patients (44.3%) had O blood group. The most common symptom of the patients was bleeding 43(61.4%).
Conclusion: The incidence of molar pregnancy was high compared with other parts of the world and the prevalence of partial hydatidiform mol was higher than other studies. The risk factors for molar pregnancy were: history of molar pregnancy, and O positive blood group. The most common clinical manifestation of molar pregnancy was bleeding.

Keywords


  1. Joneborg U, Eloranta S, Johansson AL, Marions L, Weibull CE, Lambe M. Hydatidiform mole and subsequent pregnancy outcome: a population-based cohort study. Am J Obstet Gynecol 2014; 211(6):681.e1‐681.e6817.
  2. Steigrad SJ. Epidemiology of gestational trophoblastic diseases. Best practice & research Clinical obstetrics & gynaecology 2003; 17(6):837-47.
  3. Ziaie T, Khanjani H, Yazdani MA. Survey risk factors in pregnant women who suffer from hydatidiform mole and its clinical course in Alzahra hospital in Rasht from 2003-2007. Journal of Holistic Nursing And Midwifery 2010; 20(63):27-32.
  4. Muminhodzic L, Bogdanovic G, Ljuca D, Babovic A. Epidemiological factors and pathomorphologic characteristics of hydatidiform mole. Journal of Health Sciences 2013; 3(2).
  5. Sebire NJ, Makrydimas G, Agnantis NJ, Zagorianakou N, Rees H, Fisher RA. Updated diagnostic criteria for partial and complete hydatidiform moles in early pregnancy. Anticancer Res 2003; 23(2C):1723‐1728.
  6. Rezavand N, Seyedzadeh SA. Study of Hydatiform Mole Frequency and Some Relative Risk Factors. Avicenna journal of clinical medicine (scientific journal of hamadan university of medical sciences and health services) 2009; 16(3):27-33.
  7. Garrett LA, Garner EI, Feltmate CM, Goldstein DP, Berkowitz RS. Subsequent pregnancy outcomes in patients with molar pregnancy and persistent gestational trophoblastic neoplasia. J Reprod Med 2008; 53(7):481‐486.
  8. Sebire NJ, Fisher RA, Foskett M, Rees H, Seckl MJ, Newlands ES. Risk of recurrent hydatidiform mole and subsequent pregnancy outcome following complete or partial hydatidiform molar pregnancy. BJOG 2003; 110(1):22‐26.
  9. Sebire NJ, Foskett M, Fisher RA, Rees H, Seckl M, Newlands E. Risk of partial and complete hydatidiform molar pregnancy in relation to maternal age. BJOG 2002; 109(1):99‐102.
  10. Altman AD, Bentley B, Murray S, Bentley JR. Maternal age-related rates of gestational trophoblastic disease. Obstet Gynecol 2008; 112(2 Pt 1):244‐250.
  11. Hancock BW, Nazir K, Everard JE. Persistent gestational trophoblastic neoplasia after partial hydatidiform mole incidence and outcome. J Reprod Med 2006; 51(10):764‐766.
  12. Kalantari M, Zamani A. Accuracy of Ultrasound in Diagnosis of Molar Pregnancy in Patients Admitted to Mahdieh Hospital 2001-2006. Pajoohande 2009; 13(6):543-546.
  13. Wairachpanich V, Limpongsanurak S, Lertkhachonsuk R. Epidemiology of Hydatidiform Moles in a Tertiary Hospital in Thailand over Two Decades: Impact of the National Health Policy. Asian Pac J Cancer Prev 2015; 16(18):8321‐8325.
  14. Sun SY, Melamed A, Joseph NT, et al. Clinical Presentation of Complete Hydatidiform Mole and Partial Hydatidiform Mole at a Regional Trophoblastic Disease Center in the United States Over the Past 2 Decades. Int J Gynecol Cancer 2016; 26(2):367‐370.
  15. Kirk E, Papageorghiou AT, Condous G, Bottomley C, Bourne T. The accuracy of first trimester ultrasound in the diagnosis of hydatidiform mole. Ultrasound Obstet Gynecol 2007; 29(1):70‐75.
  16. Seyedzadeh SA, Rezavand N. Study of hydatiform mole frequency and some relative risk factors. Scientific Journal of Hamadan University of Medical Sciences 2009; 16(3):27-32.
  17. Mungan T, Kuşçu E, Uğur M, Dabakoğlu T, Senses E, Cobanoğlu O. Screening of persistent trophoblastic disease with various serum markers. Eur J Gynaecol Oncol 1998; 19(5):495‐497.
  18. Behtash N, Karimi Zarchi M. Placental site trophoblastic tumor. J Cancer Res Clin Oncol 2008; 134(1):1‐6.
  19. Ghaemmaghami F, Karimi Zarchi M. Early onset of metastatic gestational trophoblastic disease after full-term pregnancy. Int J Biomed Sci 2008; 4(1):74‐77.
  20. 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; 11(4):166‐172.
  21. Shamshiri Milani H, Abdollahi M, Torbati S, Asbaghi T, Azargashb E. Risk Factors for Hydatidiform Mole: Is Husband’s Job a Major Risk Factor? Asian Pac J Cancer Prev 2017; 18(10):2657-2662.
  22. Li XL, Du DF, Chen SJ, Zheng SH, Lee AC, Chen Q. Trends in ectopic pregnancy, hydatidiform mole and miscarriage in the largest obstetrics and gynaecology hospital in China from 2003 to 2013. Reprod Health 2016; 13(1):58.
  23. Aghababaii S, Shobeiri F, Hosseinipanah SM. Hydatidiform Mole: a statistical survey in west of iran. Journal of Postgraduate Medical Institute 2016; 30(1):80-83.
  24. Mulisya O, Roberts DJ, Sengupta ES, et al. Prevalence and Factors Associated with Hydatidiform Mole among Patients Undergoing Uterine Evacuation at Mbarara Regional Referral Hospital. Obstet Gynecol Int 2018; 2018:9561413.