Background & Aims: Hydatidiform, which is one of the most dangerous emergency cases of pregnancy, is swelling and hyperplasia in the chorionic villi of the placenta, and histologically, it refers to abnormal changes in the placental villi, including trophoblastic proliferation and villous stromal edema. Moles usually occupy the uterine cavity but occasionally form in the fallopian tubes and even the ovaries. This is a rare and benign disease caused by a genetic defect in the fertilized egg. The occurrence rate of hydatidiform mole varies greatly in different parts of the world. Hydatidiform mole is diagnosed in approximately 1 in 1500-2000 pregnancies in the United States. It seems that there is a great variation in the incidence of moles, so that the incidence in the Far East and Southeast Asia is 5-15 times higher than in the industrialized countries of the West. Studies conducted in Iran have reported the prevalence of the disease differently. It seems that these differences are related to the study method, nutritional, socio-economic factors, environmental and genetic factors, as well as the size of the studied sample.
Therefore, this study was conducted to investigate the frequency of hydatidiform mole and its distribution in terms of demographic characteristics in pregnant women referred to Ali Ebne Abitaleb Educational-Medical Center in Zahedan from 2013-2018.
Methods: The present study is a cross-sectional (descriptive-analytical) study and includes all pregnant women referred to Ali Ebne Abitaleb Hospital in 2013-2018. A code of ethics (IR.ZAUMS.REC.1399.133) was received from the Research Ethics Committee of Zahedan University of Medical Sciences.
In this study, all pregnant women referred to Ali Ebne Abitaleb Zahedan Hospital in 2013-2018 were examined. All pregnant women with hydatidiform mole and with pathology confirmation and records with complete information participated in this study. People with incomplete file information or missing data and not correctly classified in the file were excluded from the study. Finally, 150 pregnant women' files were reviewed and an information form was completed for each patient. The researcher referred to the archives of Ali Ebne Abitaleb Zahedan Hospital and after providing the permits, he/she obtained the necessary files from that center and entered the required information into the required form. The investigated information included the frequency of the disease, number of pregnancies, gestational age, history of abortion, history of molar pregnancy, patient's age, blood group, contraceptive methods used, assisted reproductive methods if any, and blood group. The information was reported as aggregate data. Number (percentage) was used to describe frequency. Finally, the data was entered in an analytical software (spss/excel 16).
Results: The findings of the present study showed that, among a total of 33,730 referring pregnant women, 150 (0.005%) had a hydatidiform mole, which indicates a prevalence of 4.5 cases per 1,000 people. Out of 150 women with hydatidiform mole, women with 1 pregnancy had the highest frequency of 40 (26.7%), and women with gestational age between 10 and 20 weeks with (80%) 120, women with a history of abortion with (62%) 93, Women without a history of molar pregnancy with 124 (82.7%), women aged 20 to 30 years with 38 (38.7%), women without contraception with (65.3%) 98 and women with blood type B With (40.7%) 61 people had the highest number.
Conclusion: Molar pregnancy is one of the emergencies of pregnancy that has a relatively high prevalence and recurrence in our society and should be considered as one of the most important diagnoses in all women of reproductive age who present with bleeding. In addition, a significant relationship was observed between the history of hydatidiform mole and gestational age and disease age. In other words, various factors such as environmental factors, genetics, individual characteristics and the onset of the disease are influential. According to the results of the present study, it is suggested: A study on the relationship between hydatidiform moles in pregnant women with demographic characteristics should be conducted. Diagnosis is recommended based on clinical findings, sonography and pathology. With routine sonography in the first trimester of pregnancy, it is possible to diagnose this disease as soon as possible. Also, a center should be provided to support patients with hydatidiform mole, and prospective researches with a larger volume should be conducted in this center. May it be a big step towards early diagnosis and treatment of this disease, reducing costs and helping the country's economy and improvements.
Our results showed that a history of molar pregnancy affects the frequency of the disease. Furthermore, a significant relationship was observed between a history of hydatidiform mole and gestational age, and the age of the disease (patient's age). In other words, various factors such as environmental factors, genetics, and individual characteristics influence the prevalence of the disease.