Gestational Trophoblastic Disease in Bahrain: Prevalence, Risk Factors, and Outcomes.

Background Gestational trophoblastic disease (GTD) refers to a group of conditions linked to abnormal growth of trophoblastic tissue following conception. Although uncommon, early detection of GTD is vital due to the potential for progression and serious complications. The prevalence and presentation of GTD vary by region. In Bahrain, there are limited data on GTD, its risk factors, and clinical outcomes within the Bahraini population. Objectives To investigate the frequency, associated risk factors, and clinical outcomes of GTD among women in the Kingdom of Bahrain and to compare the findings with data reported in regional and international literature. Methods This study followed a retrospective cohort analysis. The study included all women with a confirmed diagnosis of GTD at the Salmaniya Medical Complex (SMC) between January 2018 and October 2023 (N=112). Data were collected by reviewing individual patients' files and direct communication with patients via phone to complete any missing data. Collected data included maternal demographics, risk factors, histological diagnosis, follow-up period, and the need for chemotherapy. Results The mean age of included patients was 30.7±8.5 years, while the median and interquartile range for gravidity and parity were 2 (2.5) and 1 (2), respectively. Complete hydatidiform moles, which are diploid and composed entirely of paternal genetic material, were more prevalent in our cohort (71.4%). In comparison, partial hydatidiform moles, which are typically triploid and contain both maternal and paternal genetic material, accounted for 28.6%. Gestational trophoblastic neoplasia (GTN) developed in seven patients (6.4%), with one case presenting with lung metastasis. Possible risk factors included age, consanguinity, and blood groups (O+ and B+). For β-hCG to reach zero, complete moles, on average, took slightly longer to normalize at 54.6 days compared to 48.3 days for partial moles. Conclusion Our findings can serve as a foundation for developing targeted initiatives to improve the early identification and management of GTD. We recommend conducting future prospective studies that include data from private healthcare institutions and establishing a regional registry. This would help achieve a larger sample size and allow for a more comprehensive assessment of potential risk factors and clinical outcomes associated with GTD.