Epidemiology of gestational trophoblastic neoplasm at the Dr. Cipto Mangunkusumo Hospital, Jakarta, Indonesia.

This retrospective research was conducted in the Department of Obstetrics and Gynaecology of the Dr. Cipto Mangunkusumo Hospital, Jakarta, covering the period between 1977 and 1981. The incidence of hydatidiform mole was 1 in 77 pregnancies. The incidence of malignant trophoblastic disease was 1 in 185 pregnancies. Of the 406 cases of hydatidiform mole, 22.9% became malignant. Patients of 24 years of age or younger had a higher risk of getting hydatidiform mole (P less than 0.05) compared to older patients. The risk of becoming malignant increased with age and became evident after 40 years of age. Parity 1 or less was associated with a higher risk of getting hydatidiform mole (P less than 0.05), but had no influence on hydatidiform mole becoming malignant. The influence of blood group was not so clear, although there was a tendency for moles to occur more frequently in patients with blood groups A or B. By contrast, there was a tendency for the change into malignancy to occur more frequently in women with blood groups B or O. Gestational age had no influence towards the change into malignancy or metastasis. Uterine size (greater than 20 weeks gestation) correlated with the progression of hydatidiform mole into malignancy. However, subsequent metastasis was not influenced by the size of the uterus. It was found that 76.4% of malignant trophoblastic diseases originated from hydatidiform moles, 12.4% from abortions, 9.5% from normal deliveries, and 1.2% from ectopic pregnancies. Non-hydatidiform moles had a slightly greater risk for metastasis, although this was not significant. Hydatidiform mole in histologic stages II or III (Hertig-Mansell classification) had a significantly greater tendency (P less than 0.05) to become malignant than in stage I.