Gestational trophoblastic neoplasia: are we compliant with the standards?
This study was conducted to assess the management of gestational trophoblastic diseases (GTN) in a district general hospital in accordance with the RCOG guidelines. A retrospective case notes review over a 5-year period found a total of 23 patients treated in this hospital. The annual incidence of hydatidiform mole was 1.3/1,000 deliveries (3,500 deliveries per annum). Ultrasound scanning diagnosed or suspected GTN in only nine of the 23 cases (39%); six women (26%) were diagnosed as missed miscarriage and another six (26%) were diagnosed as incomplete miscarriage. Eleven patients (48%) were not suspected before histological diagnosis. A total of 16 of the 23 cases (70%) were complete moles and the rest were partial moles; 19 of the 23 (83%) were referred to a specialist centre of which 60% were referred within 1 month. The rest were not documented. Contraceptive advice was documented only in 11 case notes (48%). Women with molar pregnancy should be referred to a specialist centre as early as possible and within 2-4 weeks of histological diagnosis, after appropriate counselling and contraceptive advice.
Thirumagal
B
B
Department of Obstetrics and Gynecology, City Hospital, Birmingham, UK. tbavananthan@hotmail.com
Sinha
D
D
Raghavan
R
R
Bhatti
N
N
D000293:Adolescent; D000328:Adult; D005260:Female; D019983:Guideline Adherence; D006767:Hospitals, District / Q000706:statistics & numerical data; D006801:Humans; D006828:Hydatidiform Mole / Q000175:diagnosis* / Q000601:surgery; D010043:Outcome and Process Assessment, Health Care; D011247:Pregnancy; D012189:Retrospective Studies; D055815:Young Adult