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Gestational Trophoblastic disease in New Zealand, 1980 — 1986
Author(s) -
Duff G.B.
Publication year - 1989
Publication title -
australian and new zealand journal of obstetrics and gynaecology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.734
H-Index - 65
eISSN - 1479-828X
pISSN - 0004-8666
DOI - 10.1111/j.1479-828x.1989.tb01703.x
Subject(s) - medicine , gestational trophoblastic disease , obstetrics , incidence (geometry) , presentation (obstetrics) , pregnancy , abortion , gynecology , molar pregnancy , population , gestation , genetics , physics , environmental health , optics , biology
EDITORIAL COMMENT: This community based study reports an incidence of hydatidiform mole ofl in 1,497pregnancies in New Zealand, including spontaneous abortions, terminations of pregnancy and ectopic pregnancies. In 21% of the 299 histologically confirmed cases, the diagnosis of hydatidiform mole was made only, when the specimen was examined by a pathologist, illustrating the importance of routine examination of curettings. Analysis of the symptoms and signs on presentation indicated that the ‘classical’ presentation of hydatidiform mole (uterus large for dates, severe hyperemesis ± preeclampsia) is the least common. The most common presenting symptom was bleeding, illustrating the importance of ultrasonography in all patients with a threatened abortion. In this series the incidence of malignant sequelae was 10.9%. Summary: During the period 1980 to 1986 inclusive 350 cases of gestational trophoblastic disease were recorded within New Zealand; of these cases nearly 70% were reported to a Register established to obtain epidemiological information. Clinical information obtained with the notifications revealed no difference in incidence of gestational trophoblastic disease among the 3 main ethnic groups which make up the New Zealand population; the uterine fundus was recorded as being large for dates in only 26%; the most common clinical presentation was as a threatened abortion; 7% of the cases were diagnosed at either routine ultrasound examination or at termination of pregnancy, there having been no suspicions prior to that procedure. A review of histological material obtained following notification suggested that the histological diagnosis of trophoblastic disease could not be substantiated in 14.7% of cases. During the period under review, therefore, there were 299 cases of trophoblastic disease (all but 2 of which were hydatidiform mole) and 447,667 pregnancies giving an incidence of 1 case of trophoblastic disease per 1,497 pregnancies.