A. Chaoui

Les maladies gestationnelles trophoblastiquesÀ propos de 105 cas

The authors report a retrospective study of 105 observations of gestational trophoblastic diseases managed at the university clinic of obstetric gynecology I (Pr Chaoui). Of this study, one listed 72 cases of complete mole hydatiforme with 5 cases of sacrofetal pregnancy. The invasive mole is found in 4 cases and the choriocarcinoma in 24 cases. The general frequency of this pathology is of 1/770 pregnancies. The age of our patients varies from 15 to 52 years with an average age 27 years and the multiparity is found in 50% of the cases. 103 patients (95.5%) consulted for metrorrhagia associated pelvic pains in 31 cases (30%). The toxic syndrome was present in 20 patients (12%) with a preeclampsy in 6 cases (5.71%). The physical examination showed a very increased uterus of size in 92 cases (87.5%) associated adnexal mass in 37 cases (35.2%). The diagnosis was especially echographic in the totality of the cases associated or not with a proportioning of plasmatic beta HCG or prolans urinary. The treatment of the trophoblastic disease varies simple endo-uterine aspiration (85%) until the chemotherapy treatment (32.4%), the hysterectomy was indicated in a third of the cases. The evolution of the non complicated mole hydatiforme was good in 100% of the cases, it quasi totality of the invasive moles presented a complete remission. Among the 24 choriocarcinoma, we deplore 4 deaths in a table of pulmonary, hepatic and cerebral metastases. In order to improve the forecast of these diseases, the diagnosis must be early with an adequate treatment and a rigorous monitoring.