Department of Clinical Nursing, School of Nursing, University of Dodoma, 259 Dodoma, Tanzania.
Department of Pathology, School of Medicine, Muhimbili University of Health and Allied Sciences, 65001, Dar es Salaam, Tanzania.
Int Health. 2023 May 2;15(3):250-257. doi: 10.1093/inthealth/ihac015.
Gestational trophoblastic diseases (GTDs) may follow any form of pregnancy or a pregnancy loss. Early detection of GTDs is important, as some benign forms of the disease may progress into a chemoresistant and metastatic disease. This study aimed at determining the frequency of GTDs among women experiencing first trimester pregnancy loss and the associated patients' characteristics.
This was a cross-sectional study that included 200 conveniently sampled women who experienced first trimester pregnancy loss from January to December 2019 at a Regional Referral Hospital in central Tanzania. The specimen obtained from products of conception were collected, formalin-fixed and paraffin-embedded and submitted for histopathological evaluation, for which haematoxylin and eosin stain was used. Data were analysed using SPSS version 23.0. The χ2 test was used to determine the association between categorical variables. p-Values ˂0.05 were considered statistically significant.
Among 200 study participants, the overall frequency of GTDs was 42 (21%). Among those with GTDs, the most common histopathological diagnosis was partial hydatidiform mole (18 [42.9%]), followed by complete hydatidiform mole (17 [40.5%]) and choriocarcinoma (7 [16.5%]). In the studied participants, only increased human chorionic gonadotropin hormone levels were found to be statistically significantly associated with GTDs (p=0.000).
Results from this study suggest that routine histopathological evaluation of the products of conception is recommended in order to allow early detection of GTDs, including choriocarcinoma, which usually carries a poor prognosis. The histopathological reporting of choriocarcinoma among first trimester products of conception from Tanzania is novel.
滋养细胞肿瘤（GTD）可能发生于任何形式的妊娠或妊娠丢失之后。早期发现 GTD 很重要，因为一些良性形式的疾病可能进展为耐药和转移性疾病。本研究旨在确定在坦桑尼亚中部一家区域转诊医院经历早期妊娠丢失的女性中 GTD 的发生率以及相关患者特征。
这是一项横断面研究，纳入了 2019 年 1 月至 12 月期间在坦桑尼亚中部一家区域转诊医院经历早期妊娠丢失的 200 名方便抽样女性。从妊娠产物中采集标本，福尔马林固定和石蜡包埋，并提交进行组织病理学评估，使用苏木精和伊红染色。使用 SPSS 版本 23.0 分析数据。使用 χ2 检验确定分类变量之间的关联。p 值<0.05 被认为具有统计学意义。
在 200 名研究参与者中，GTD 的总发生率为 42（21%）。在 GTD 患者中，最常见的组织病理学诊断是部分葡萄胎（18 [42.9%]），其次是完全葡萄胎（17 [40.5%]）和绒毛膜癌（7 [16.5%]）。在研究参与者中，仅发现人绒毛膜促性腺激素水平升高与 GTD 具有统计学显著关联（p=0.000）。
本研究结果表明，建议对妊娠产物进行常规组织病理学评估，以便早期发现 GTD，包括绒毛膜癌，其预后通常较差。来自坦桑尼亚的早期妊娠产物绒毛膜癌的组织病理学报告是新颖的。
