MAGNITUDE, ASSOCIATED FACTORS AND POST-EVACUATION FOLLOW-UP OF GESTATIONAL TROPHOBLASTIC DISEASE AMONG DELIVERIES IN HIWOT FANA SPECIALISED UNIVERSITY HOSPITAL, HARAR, EASTERN ETHIOPIA.

Abstract

Background: Gestational Trophoblastic Disease is a spectrum of interrelated conditions but histologically distinct disease entities originating from placenta. It can be associated with significant morbidity and mortality in the absence of timely and proper intervention. The prevalence of the disease has demonstrated marked geographic and ethnic differences throughout the world. When the regulatory mechanisms fail, it may result in tumors that are highly invasive, metastatic, and very vascular. Virtually all malignant of this disease is curable if detected early and treated promptly and aggressively. In eastern part of Ethiopia there is no published study of this disease. Therefore, this study will also provide information about the magnitude of this disease especially in eastern part of the country. Objectives:The aim of this study was to assess the magnitude, associated factors and post-evacuation follow-up of Gestational trophoblastic disease among deliveries at Hiwot Fana Specialized University Hospital in Harar, eastern Ethiopia from April 1, 2017 toOctober 30, 2022. The extraction period of the data was from November 1 to 30, 2022. vii Methods: Retrospective hospital-based cross-sectional study was conducted to determine the prevalence and associated factors of Gestational Trophoblastic Disease cases managed from April 1, 2017 to October 30, 2022. Data related to socio-demographic and clinical variables was collected using structured questionnaire and checklist. Data processing and analysis was done using SPSS statistical software version 25. Bivariate multiple logistic regressions analysis was performed to assess the association between dependent and independent variables. The degree of association between dependent and independent variables will be assessed using odds ratio with 95% confidence interval and P-value <0.05. Results: A total of 181 GTD cases were eligible for analysis during the period of study and 9 were excluded from the study due to incomplete data due to failure to meet the inclusion criteria,making the prevalence of GTD in HFSUH 10.5/1000 deliveries in which 95.6% of them were complete mole while 4.4% of them were complete mole. Previous history of spontaneous abortion, (p=0.044, AOR=7.4, CI=1.051-52.980), Para 2-4, (p=0.031, AOR=12.3, CI=12.3(1.075-141.930), Previous history of GTD, (p=0.05, AOR=1.2, CI= 0.489-9.86) were factors associated with Gestational trophoblastic disease in our study. Conclusion: The magnitude of GTD is high which is in line with other studies done in Jimma (7.2 per 1000 deliveries) and Hawassa (11.4/1000 deliveries) but lower 1/115 deliveries in Mekelle Northern Ethiopia and Uganda 6.1% (11/181).We recommend to have a clear plan for post-surgical contraception, post evacuation follow-up B-HCG levels, histopathology or biopsy reports and a major benchmark for adequate care in patients with GTD