Assessment of Epidemiological and Hormonal Parameters among patients with Hydatidiform Mole

Abstract

Background: Gestational trophoblastic disease encompasses several disease processes that originate in the placenta. These include complete and partial moles, placental site trophoblastic tumors, choriocarcinomas and invasive moles.
Aim: This study was aimed to evaluate best marker for diagnosis and follow up of Hydatidiform mole (HM) and evaluate some immunological parameters.
Materials and Methods: Forty patients with Hydatidiform Mole (HM) attended Hawler Maternity Teaching Hospital were enrolled in this study in addition to 10 healthy pregnant women in 1st trimester served as a control group , the sampling period lasted one year . In this study, many epidemiological, hormonal and immunological parameters were evaluated.
Results: This study shows relation between risk factors and development of HM. Among these factors is age, it revealed that the most frequent age group for HM was between (25-34) year when compared with other age groups. The frequency of development HM among the housewives was [37/40 (92.5%)] and more than the official or educated women which was [3 (7.5%)]. The frequency of HM among patients with blood group B and O, [14 (35%) & 14 (35%) respectively] were higher than those with blood group A and AB. The results showed that the number of patients with body mass index (BMI) of (18.50 - 24.99 kg/m²) were higher. The highest frequency (90%) of HM was among patients whom married at period “between” (1993 - 2010). The percentage of patients with HM having history of abortion was higher (87.5%) than in those without abortion. There were no relation between HM and history of using oral contraceptive (40%).Mean concentration of β-HCG hormone in sera of patients showed a significant elevation before dilatation and curettage (D&C) as compared to mean concentration of β-HCG in control group (healthy pregnant women in 1stTrimester). After D & C, the mean concentration in sera of the same patients significantly decreased after 10 days as compared with mean concentration of β-HCG in sera of patients before D & C. However, no significant change recorded between mean concentration of β-HCG in patients sera after D&C and control group (P = 0.5).
The mean concentration of Inhibin-A hormone in the sera of patients before D&C was significantly higher as compared to control group. However, after D&C the mean concentration of Inhibin-A sharply decreased in sera of same patients after 10 days (P =0.0001) as compared with mean concentration of Inhibin-A in patients sera before D&C and control group. No significant change (P=0.41) recorded in mean concentration of Carcino Embryonic Antigen (CEA) before and after D&C. While, there was significant difference between mean concentration of CEA in patients after D&C and control group (P = 0.003).
Conclusion: The best diagnostic and follow up marker for HM was Inhibin-A. Blood group B and O, BMI of (18.50 - 24.99 kg/m²), (25-34) year's age group and women who married at period “between” (1993 - 2010) were highest frequency of HM.