Molar Pregnancy in Nnamdi Azikiwe University Teaching Hospital, Nnewi, Nigeria: a 10 -Year Review

Abstract

Background: Molar pregnancy, also known as hydatidiform mole, is a type of gestational trophoblastic disorder that normally arises from disorders of placental trophoblastic tissue proliferation. If not properly managed, it can be an important cause of maternal morbidity and mortality.

Objective: This study was to determine the prevalence and clinical outcome of molar pregnancies in Nnamdi Azikiwe University Teaching Hospital, Nnewi, Nigeria.

Materials and Methods: This is a retrospective study of all cases of molar pregnancies managed in Nnamdi Azikiwe University Teaching Hospital (NAUTH), Nnewi, South-east Nigeria, from January 1, 2012 to December 31, 2021 (ten-year period). Folders of patient managed for molar pregnancy during the study period served as source of data. Data were analyzed using Statistical Package for the Social Sciences (SPSS) 26.0 IBM Corporation.

Result: A total of 56 cases of molar pregnancies were diagnosed and managed within the 10-year review period, with a total delivery of 8194 giving a prevalence of 0.7% or 7 per 1000 deliveries. Within the same period, there were 5892 gynaecological admissions and molar pregnancy accounted for 1%. The mean age of the patients was 29.4 ± 4.4 years, however, most of the patients (73%) were within the age range of 26-35 years. Most of the patients managed presented in their first trimester (73%) with the commonest presenting complaints being amenorrhoea (100%), vaginal bleeding (94%) and abdominal pain (77%). The commonest complication recorded was anaemia (92%) while ultrasonography was instrumental in the diagnosis of 92% of cases. Majority of the patients (96%) were treated through suction evacuation while 4% were offered hysterectomy. More than 80% of those treated for molar pregnancies used contraception afterward with most of them favouring the male barrier method. Only 69% of the patients were followed up for at least 6 months, while 8% of the patients were followed up for more than 6 months and 21% of the patients were lost to follow up. The case fatality rate for this study was 2%.

Conclusion: Molar pregnancy accounted for 1% of all gynaecological admissions with an incidence of 7 per 1000 deliveries. It continues to be a significant contributor to maternal mortality and morbidity at our facility. Early recognition, immediate referral, and appropriate management will go a long way to curb the maternal mortality and morbidity from molar pregnancy. Proper patient education and adequate patient follow-up should also be reinforced.