1132 Epidemiological and clinical profile of gestational trophoblastic diseases in Kairouan: retrospective study of 122 cases

Introduction/Background Gestational trophoblastic disease (GTD) encompasses a broad spectrum of pathologies ranging from benign precancerous lesions, partial and complete hydatidiform mole (respectively MHP and MHC), to malignant lesions, invasive mole, choriocarcinoma and tumors of the implantation site. Malignant forms of gestational trophoblastic disease are generally referred to as gestational trophoblastic tumors (GTT). Methodology To provide an update on this disease, we conducted a retrospective study of 122 cases of gestational trophoblastic disease collected at the Kairouan Obstetric Gynecology Department over an 11-year period from January 1, 2011 to December 31, 2020. Results During the study period, from January 1, 2011 to December 31, 2020, we collected 122 cases of TGD, representing an average incidence of 11.9 cases per year. The median age of patients was 33.50 +/- 9.94 years, with extremes ranging from 17 to 54 years. The majority of women were of modest socio-economic status, with a frequency of 61.5%. Blood group A was predominant with a frequency of 33.6% . However, group O was noted in only 23% of cases. The main reason for consultation was abnormal bleeding. It was reported in 88 patients (72.1%). Anatomopathological examination confirmed the diagnosis in almost all cases and specified the type of GTT. Thus, we identified: complete hydatidiform mole in 83 cases (68%); partial mole in 36 cases (29.5%); tumor of the implantation site in one case; invasive mole in one case. Only 32 patients did not benefit from anatomopathological examination. The diagnosis of gestational trophoblastic tumor was made in view of the B HCG kinetics. Conclusion Gestational trophoblastic disease (GTD) arises from abnormal placenta and is composed of a spectrum of premalignant to malignant disorders. This pathology should be more studied. Disclosures This pathology remains mysterious in many points . Indeed, it poses numerous problems: 1/Morphological: There are no absolute criteria for histologically distinguishing the different entities of trophoblastic disease, and above all for establishing the evolutionary potential of a mole. ¬ 2/Diagnosis: Diagnosis is based on a combination of clinical, ultrasonographic, biological and histological data. 3/Evolutionary: Problems arise from the difficulty of identifying moles with a poor prognosis ¬ -4/Therapeutic: Problems arise from differences of opinion concerning the role of chemoprophylaxis.