"Molar pregnancy in Pietersburg Hospital, Limpopo Province, South Africa"

Abstract

Objectives: To investigate Molar pregnancy [Hydatidiform mole] in Pietersburg hospital, a part of tertiary hospital Pietersburg – Mankweng hospital complex in Limpopo Province. South Africa. Methods: This was a retrospective cross-sectional descriptive study with quantitative data collection methods, conducted among the patients admitted in Gynaecology ward in Pietersburg hospital with early pregnancy complications such as miscarriages including molar pregnancy [Hydatidiform mole] from January 2021 to December 2021. Consecutive sampling was used to select 280 patients who were admitted with above mentioned diagnosis and underwent for uterine evacuation. Data was collected on demography, clinical features, sonographic findings, and laboratory results including histology results of products conception of the patients diagnosed with confirmed Hydatidiform mole [HM] by histology. Data was analysed using STATA software and thematic analysis. Results: About 280 patients were admitted with early pregnancy complications such as miscarriages, molar pregnancy at gynaecology ward and underwent for uterine evacuation during a year from January 2021 to December 2021. Patient with ectopic pregnancy and Gestational Trophoblastic Neoplasia [GTN] were excluded from this study. Twenty-six patients were diagnosed as confirmed Hydatidiform mole [HM] by histological examination of products of conception, which is the gold standard for diagnosing HM, the mean age of the patient was 31.7 years and mean parity was 2.6. Prevalence of Hydatidiform mole was 9.3%. Approximately 85% patient with HM referred from peripheral hospital around the province and rest came from around Polokwane city where Pietersburg hospital situated as self-referral or referred by general medical practitioners. About 85% patient with HM had complete Hydatidiform mole [CHM] and 15% had partial Hydatidiform mole [PHM] on histological examination of products of conception. One patient was found to have choriocarcinoma [Gestational Trophoblastic Neoplasia] who was excluded from this study. The common presentation of majority of the patients [81%] was vaginal bleeding mostly during 14 to 20 weeks of pregnancy, only 15% did not have vaginal bleeding rather had the v features of HM on routine ultrasound examination. No patient with HM had metastatic disease and approximately 8% had severe anaemia and preoperative/intraoperative blood transfusion. Conclusion: Geography and ethnicity play a factor in the prevalence of Hydatidiform mole (HM) worldwide. This study was conducted at Pietersburg hospital in South Africa's Limpopo province, even though it had a small sample size, the results showed that the prevalence of HM was 9.3% or 1 in every 11 patients admitted to the Gynaecology ward with miscarriages or molar pregnancies over one year. As women with HM and miscarriages often present with similar symptoms, clinicians should be vigilant about the risks and complications of HM. Early diagnosis, treatment, and follow-up care are critical in managing HM and preventing metastatic disease or Gestational Trophoblastic Neoplasia (GTN), ultimately preventing fatalities from this condition