title: Gestational trophoblastic disease in Tunisia.
abstract: OBJECTIVE
  The aim of our study is to evaluate the frequency of the gestational trophoblastic disease (GTD) in Tunisia, and describe its risk factors and clinical presentations. We also precise therapeutic features used in our country and compare them to those proposed in the literature and finally suggest concrete recommendations.
  
  
  METHODS
  We studied retrospectively the cases of GTD proved histologically, occurring during the three years (2000-2001-2002) in the departments of genecology obstetrics of Tunisia and the department of medical oncology of the Salah Azaiz Cancer Institute.
  
  
  RESULTS
  The frequency of the GTD in Tunisia is 1 per 918 deliveries. The frequency of the CHM (complete hydatiform mole) is estimated to 68.15% of all the cases of GTD and 1 per 1347 deliveries whereas the frequency of the PHM (partial) is estimated to 30.57% and 1 per 3004 deliveries. The mean gestational age at the moment of the diagnosis is of 11.5 week of amenorrhea (WA) for CHM and 11 WA for the PHM. The metrorrhagia is present in 75% of the CHM and 67% of the PHM. Ultrasonography showed a typical snowstorm aspect in 55%. The mean rate of HCG is 162 x 10(3) UI/l. Vacuum aspiration was performed in all the CHM and in 89.5% of the PHM. One patient followed up for PHM was treated by hysterectomy. 21% of the cases were complicated by trophoblastic retention. Two patients were treated by initial chemotherapy for invasive mole and metastatic mole. 84% of the patients reached complete healing. After treatment of the molar pregnancy, two patients (1.27%) recurred.
  
  
  CONCLUSIONS
  Our results suggest some recommendations: In our practice, all abortion products must be addressed to histopathological examination. The patients must be surveyed during at least one year to detect the occurrence of a GTN. The classification and treatment of the GTN must be codified Modem therapy for gestational trophoblastic diseases (GTDs) has resulted in high cure rates while preserving fertility.
authors.affiliation: Service de Gynéco-obst, Hôpital Mahmoud El Matri, Ariana.
authors.forename: Mechaal
authors.initials: M
authors.lastname: Mourali
authors.forename: Chiraz
authors.initials: C
authors.lastname: Fkih
authors.forename: Jihène
authors.initials: J
authors.lastname: Essoussi-Chikhaoui
authors.forename: Amine
authors.initials: A
authors.lastname: Ben Haj Hassine
authors.forename: Naoufel
authors.initials: N
authors.lastname: Binous
authors.forename: Nabil
authors.initials: N
authors.lastname: Ben Zineb
authors.forename: Hammouda
authors.initials: H
authors.lastname: Boussen
mesh_terms: D000293:Adolescent; D000328:Adult; D005260:Female; D005865:Gestational Age; D006801:Humans; D006828:Hydatidiform Mole / Q000175:diagnosis / Q000453:epidemiology* / Q000628:therapy; D008595:Menorrhagia / Q000209:etiology; D008875:Middle Aged; D011247:Pregnancy; D012189:Retrospective Studies; D014416:Tunisia / Q000453:epidemiology; D014619:Vacuum Curettage