Gestational Trophoblastic Disease: Prevalence, Management and Follow-Up at a Tertiary Center in Oman—An 11-Year Study

  • Fatma Al Wahaibi
  • Huda Al Ghaithi
  • Ruqiya AlShamsi
  • Vaidyanathan GowriEmail author
  • Thuria Al Rawahi
Original Article



The objective of this study is to estimate the prevalence, management and follow-up of gestational trophoblastic disease (GTD) in a tertiary care center, Royal Hospital, in Oman over the last 11 years from January 2007 till December 2017. This study also looked into the reproductive outcome after trophoblastic disease treatment.


This retrospective, descriptive study was carried out at Royal Hospital from Jan. 2007 to Dec. 2017. All cases with a histopathological report of hydatidiform molar disease were included. Demographic characteristics, clinical presentation physical signs, treatment and follow-up including reproductive outcome and recurrence rate were included.


Two hundred and thirty-six women with GTD were included in the study. Mean maternal age was 35 years, mean gravidity 5 and parity 3. Prevalence of complete mole was 83 cases (35.1%), partial mole 144 cases (61%), choriocarcinoma (0.42%), placental site (0.42%) and invasive mole (1.27%). Thyrotoxicosis, preeclampsia and anemia were 3.8%, 7.2% and 0.8%, respectively. Mean gestational age was 10.57 ± 3.2 weeks at presentation. Persistent disease was observed in 12.3%. About 5% received chemotherapy. Metastasis was reported in 4.7% of cases, 81.8% to the lung. About 38% conceived later.


This study highlights the importance of proper assessment and follow-up of histopathology diagnosis. GTD usually has a good prognosis and reproductive outcome if properly followed up and treated.


Gestational trophoblastic disease Molar pregnancy Partial molar pregnancy Metastases Prevalence 




Compliance with Ethical Standards

Conflict of interest

The authors declare that they have no conflict of interest.


  1. 1.
    Lurain JR. Gestational trophoblastic disease I: epidemiology, pathology, clinical presentation and diagnosis of gestational trophoblastic disease, and management of hydatidiform mole. Am J Obstet Gynecol. 2010;203(6):531–9.CrossRefGoogle Scholar
  2. 2.
    Gestational trophoblastic disease, New Zealand gynaecologic cancer group guidelines, March 2018.
  3. 3.
    Loukovaara M, Pukkala E, Lehtovirta P, Leminen A. Epidemiology of hydatidiform mole in Finland, 1975 to 2001. Eur J Gynaecol Oncol. 2005;26(2):207–8.PubMedGoogle Scholar
  4. 4.
    Garner EI, Goldstein DP, Feltmate CM, Berkowitz RS. Gestational trophoblastic disease. Clin Obstet Gynecol. 2007;50(1):112–22.CrossRefGoogle Scholar
  5. 5.
    Ahmed IAM. Gestational trophoblastic disease in Al-Thawra Hospital, Sana’a-Yemen. Yemeni J Med Sci. 2013;7.Google Scholar
  6. 6.
    Al Alaf SK, Ibrahim D. Prevalence and clinical observations of gestational trophoblastic diseases in maternity teaching hospital in Erbil city. WSEAS Trans. Biol. Biomed. 2010;7(3):190–9.Google Scholar
  7. 7.
    Javey H, Sajadi H. Hydatidiform mole in southern Iran: a statistical survey of 113 cases. Int J Gynaecol Obstet. 1978;15(5):390–5. Scholar
  8. 8.
    Seckl MJ, Sebire NJ, Berkowitz RS. Gestational trophoblastic disease. Lancet. 2010;376:717–29.CrossRefGoogle Scholar
  9. 9.
    Ngan HY, Kohorn EI, Cole LA, Kurman RJ, Kim SJ, Lurain JR, Seckl MJ, Sasaki S, Soper JT. Trophoblastic disease. Int J Gynaecol Obstet. 2012;119(Suppl 2):S130–6. Scholar
  10. 10.
    Seckl MJ, Sebire NJ, Fisher RA, Golfier F, Massuger L, Sessa C, ESMO Guidelines Working Group Annals of Oncology. Gestational trophoblastic disease: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Ann Oncol. 2013;24(suppl_6):vi39–50. Scholar
  11. 11.
    Al Riyami N, Al Riyami M, Al Hajiri T, Al Saidi S, Salman B, Kalbani M. Gestational trophoblastic disease at Sultan Qaboos University Hospital: prevalence, risk factors, histological features, sonographic findings, and outcomes. Oman Med J. 2019;34(3):200–4. Scholar
  12. 12.
    Yuk J, Baek JC, Park JE, Jo HC, Park JK, Cho IA. Incidence of gestational trophoblastic disease in South Korea: a longitudinal, population-based study. PeerJ. 2019;7:e6490. Scholar
  13. 13.
    Jagtap SV, Aher V, Gadhiya S, Jagtap SS. Gestational trophoblastic disease—clinicopathological study at Tertiary Care Hospital. J Clin Diagn Res. 2017;11(8):EC27–30. Scholar
  14. 14.
    Seckl MJ, Sebire NJ, Berkowitz RS. Gestational trophoblastic disease. Lancet. 2010;376(9742):717–29. Scholar
  15. 15.
    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;23:1723–8.PubMedGoogle Scholar
  16. 16.
    Feltmate CM, Growdon WB, Wolfberg AJ, Goldstein DP, Genest DR, Chinchilla ME, Lieberman ES, Berkowitz RS. Clinical characteristics of persistent gestational trophoblastic neoplasia after partial hydatidiform molar pregnancy. J Reprod Med. 2006;51(11):902–6.PubMedGoogle Scholar
  17. 17.
    Hancock BW, Nazir K, Everard JE. Persistent gestational trophoblastic neoplasia after partial hydatidiform mole incidence and outcome. J Reprod Med. 2006;51(10):764–6.PubMedGoogle Scholar
  18. 18.
    Zhou X, Chen Y, Li Y, Duan Z. Partial hydatidiform mole progression into invasive mole with lung metastasis following in vitro fertilization. Oncol Lett. 2011;3(3):659–61. Scholar
  19. 19.
    Li X, Xu Y, Liu Y, Cheng X, Wang X, Lu W, Xie X. The management of hydatidiform mole with lung nodule: a retrospective analysis in 53 patients. J Gynecol Oncol. 2018;30(2):e16. Scholar

Copyright information

© Association of Gynecologic Oncologists of India 2019

Authors and Affiliations

  1. 1.Obstetrics and Gynecology Residency Training ProgramOman Medical Specialty BoardMuscatOman
  2. 2.Obstetrics and Gynecology DepartmentRoyal HospitalMuscatOman
  3. 3.Department of HistopathologyRoyal HospitalMuscatOman
  4. 4.Obstetrics and Gynecology Department, College of Medicine and Health SciencesSultan Qaboos UniversityMuscatOman

Personalised recommendations