Browsing by Author "Ravikumar, Dinesh"

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    Clinical Profile Of Patients With Gestational Trophoblastic Disease From India- A Single Tertiary Care Center Experience
    (Indian Society for Health and Advanced Research, 2023-09) Paul, Ashvin J; Gowrishanka, Bommi; Ravikumar, Dinesh; Kumar, E. Senthil; K, Siva Subramaniam.
    Introduction: Gestational trophoblastic disease ( GTD) comprises of lesions arising from abnormal trophoblastic proliferation of placenta with a spectrum ranging from benign to malignant disease. Benign non neoplastic lesions are known as hydatidiform mole and malignant lesions are referred as gestational trophoblastic neoplasia. Aim: The aim of the study is to analyze the demographic , clinical, biochemical variables of treatment response. Materials And Methods: total number of 58 patients were analyzed retrospectively from January 2019 to January 2020 based on medical records. Details regarding demographic , pathological and beta human chorionic gonadotropin ( beta-HCG) pre-suction/post suction values were collected. Descriptive statistical analysis was done using SPSS software Results: Mean age of patients in this study was 24 +/- 5.48 years. mean gestational age of 11.8 +/- 2.3 weeks. Asymptomatic presentation was seen in 26 patients ( 44.8 %) were detected through routine antenatal ultrasound screening . 25 ( 43.1 %) patients presented with spotting per vagina and 7 ( 12.1 %) patients presented with hyperemesis gravidarum. Among 58 patients Hydatidiform mole was diagnosed in 46 patients ( 79.31 %) and con?rmed by HPE reports and serial monitoring of Beta HCG. Among 46 patients, 34 ( 58.6 %) had complete and 12 ( 20.68 %) patients had partial mole . 12 patients with Gestational trophoblastic neoplasia was con?rmed by post suction HPE report . Out of which 9 patients had invasive mole and 3 patients had choriocarcinoma subsequently. Among 58 patients, 38( 65.51 %) patients had beta- HCG value more than 1,00,000 IU/ml. Mean pre-suction beta HCG was 3,06,181 +/- 4,53,172 IU/ml. Mean time to undetectable beta-HCG post suction was 92.5 +/- 50.79 days. Majority of them had A positive blood group ( 34.48 %) and were primigravida ( 51.72 %). Out of the 58 patients, 25 (43.1%) of them received single agent chemotherapy either with actinomycin or methotrexate and 12 (20.7%) patients were treated with EMA-CO regimen ( etoposide, methotrexate, actinomycin, cyclophosphamide, vincristine). 4 ( 6.9 %) patients not responding to single agent with elevated BHCG were treated with dual agents. 17 ( 29.3%) of them required only observation. There was no mortality observed in this study. Conclusion: patients with GTD have to be properly risk strati?ed and timely referral to an experienced tertiary care center can make a difference in bringing down morbidity and mortality.