The prevalence of molar pregnancy among patients with incomplete miscarriage at a maternity teaching hospital

GTD associated with incomplete miscarriage


  • Zheen Hazim Ali Erbil Directorate of Health, Erbil, Iraq.
  • Parez Redha Mohammed Department of Obstetric and Gynaecology, College of Medicine, Hawler Medical University, Erbil, Iraq.



Gestational trophoblastic disease, GTD, Miscarriage, Incomplete miscarriage


Background and objective: Gestational trophoblastic disease (GTD) involves a range of interrelated disorders that originate from the placenta; it can be benign or malignant. In the Kurdistan region of Iraq, data about GTD and its consequences is scarce. This study aims to identify the prevalence of GTD and its types among a cohort of Kurdish women. 

Methods: A cross-sectional study was conducted for a one-year duration from April 1, 2020, to April 1, 2021, at the Emergency Department of Maternity Teaching Hospital, Erbil City. Pregnant women in their first trimester and early second trimester (4–14 weeks of gestation) with vaginal bleeding, pregnant women with vaginal bleeding due to incomplete miscarriage, and pregnant women with a history of missed miscarriage were included in the study. A specialized questionnaire was prepared for the purpose of data collection.

Results: Out of 380 incomplete miscarriage cases who were interviewed, fifty patients with gestational trophoblastic disease were included in the current study. The prevalence of GTD was 13.1%, and the majority of patients had a partial type of GTD. The current analysis indicated that there was a statistically significant association between the types of GTD, the personal history of molar pregnancy, and the age of participants. The analysis indicated that there is no statistical association between parity, blood group, and history of miscarriage and the type of GTD.

Conclusion: The prevalence of GTD was remarkably high, and the partial type of GTD was the most common form present among the participants. The majority of the cases were diagnosed during the first trimester of the pregnancy. Complete GTD was more common among patients of advanced age.


Metrics Loading ...


Cancer Research UK. Gestational trophoblastic disease. 2019 [cited 2022 25th March]; Available from:

Soper JT, Mutch DG, Schink JC. Diagnosis and treatment of gestational trophoblastic disease: ACOG Practice Bulletin No. 53. Gynecol Oncol 2004; 93(3):575–85. DOI:10.1016/j.ygyno.2004.05.013.

AlJulaih GH Muzio MR, Gestational trophoblastic neoplasia, in StatPearls [Internet]. 2021, StatPearls Publishing.

Lok C, Frijstein M, van Trommel N. Clinical presentation and diagnosis of Gestational Trophoblastic Disease. Best Pract Res Clin Obstet Gynaecol 2021; 74:42–52. DOI:10.1016/j.bpobgyn.2020.12.001.

Froeling FE Seckl MJ. Gestational trophoblastic tumours: an update for 2014. Curr Oncol Rep 2014; 16(11):408. DOI:10.1007/s11912-014-0408-y.

Kaur B. Pathology of gestational trophoblastic disease (GTD). Best Pract Res Clin Obstet Gynaecol 2021; 74:3–28. DOI:10.1016/j.bpobgyn.2021.02.005.

Ngan HYS, Seckl MJ, Berkowitz RS, Xiang Y, Golfier F, Sekharan PK, et al. Update on the diagnosis and management of gestational trophoblastic disease. Int J Gynaecol Obstet 2018; 143Suppl 2:79–85. DOI:10.1002/ijgo.12615.

NIH. Gestational Trophoblastic Disease Treatment (PDQ®)–Health Professional Version. 2022 [cited 2022 25 March]; Available from:

Ozalp SS Oge T. Gestational trophoblastic diseases in Turkey. J Reprod Med 2013; 58(1-2):67–71.

Lurain JR. Gestational trophoblastic disease I: epidemiology, pathology, clinical presentation and diagnosis of gestational trophoblastic disease, and management of hydatidiformmole. Am J Obstet Gynecol 2010; 203(6):531–9. DOI:10.1016/j.ajog.2010.06.073.

Kitange B, Matovelo D, Konje E, Massinde A, Rambau P. Hydatidiform moles among patients with incomplete abortion in Mwanza City, North western Tanzania. Afr Health Sci 2015; 15(4):1081–6. DOI:10.4314/ahs.v15i4.5.

Shanbhogue AK, Lalwani N, Menias CO. Gestational trophoblastic disease. Radiol Clin North Am 2013; 51(6):1023–34. DOI:10.1016/j.rcl.2013.07.011.

Hui P. Gestational Trophoblastic Tumors: A Timely Review of Diagnostic Pathology. Arch Pathol Lab Med 2019; 143(1):65–74. DOI:10.5858/arpa.2018-0234-RA.

Seckl MJ, Sebire NJ, Berkowitz RS. Gestational trophoblastic disease. Lancet 2010; 376(9742):717–29. DOI:10.1016/s0140-6736(10)60280-2.

Milenković V Lazović B. [Gestational trophoblastic disease--literature review]. Med Pregl 2011; 64(3-4):188–93. DOI:10.2298/mpns1104188m.

Braga A, Lin LH, Maestá I, Sun SY, Uberti E, Madi JM, et al. Gestational Trophoblastic Disease in Brazil. Rev Bras Ginecol Obstet 2019; 41(4):211–2. DOI:10.1055/s-0039-1688566.

Gueye M, Ndiaye MD, Diallo M, Mbodji A, Kane Gueye SM, Moreau JC. Management of gestational trophoblastic diseases in a low resource country: establishment of a national center and its results. Med Sante Trop 2019; 29(2):213–9. DOI:10.1684/mst.2019.0904.

Soper JT. Gestational Trophoblastic Disease: Current Evaluation and Management. Obstet Gynecol 2021; 137(2):355–70. DOI:10.1097/aog.0000000000004240.

Eiriksson L, Dean E, Sebastianelli A, Salvador S, Comeau R, Jang JH, et al. Guideline No. 408: Management of Gestational Trophoblastic Diseases. J Obstet Gynaecol Can 2021; 43(1):91–105.e1. DOI:10.1016/j.jogc.2020.03.001.

Mdoe MB, Mwakigonja AR, Mwampagatwa I. Gestational trophoblastic disease and associated factors among women experiencing first trimester pregnancy loss at a regional referral hospital in central Tanzania: a cross-sectional study. International Health 2022. DOI:10.1093/inthealth/ihac015.

Al Riyami N, Al Riyami M, Al Hajri AT, Al Saidi S, Salman B, Al Kalbani M. Gestational Trophoblastic Disease at Sultan Qaboos University Hospital: Prevalence, Risk Factors, Histological Features, Sonographic Findings, and Outcomes. Oman Med J 2019;34(3):200–4.

Zakaria A, Hemida R, Elrefaie W, Refaie E. Incidence and outcome of gestational trophoblastic disease in lower Egypt. Afr Health Sci 2020; 20(1):73–82. DOI:10.4314/ahs.v20i1.12.

Shaaban AM, Rezvani M, Haroun RR, Kennedy AM, Elsayes KM, Olpin JD, et al. Gestational trophoblastic disease: clinical and imaging features. Radiographics 2017; 37(2):681–700. DOI:10.1148/rg.2017160140

Parazzini F, Mangili G, La Vecchia C, Negri E, Bocciolone L, Fasoli M. Risk factors for gestational trophoblastic disease: a separate analysis of complete and partial hydatidiform moles. Obstet Gynecol 1991; 78(6):1039–45.

Sebire N, Foskett M, Fisher R, Rees H, Seckl M, Newlands E. Risk of partial and complete hydatidiform molar pregnancy in relation to maternal age. BJOG 2002; 109(1):99–102. DOI:10.1111/j.1471-0528.2002.t01-1-01037.x

Kim C, Barnard S, Neilson JP, Hickey M, Vazquez JC, Dou L. Medical treatment for incomplete miscarriage. Cochrane Database Syst Rev 2017; 31:1:CD007223. DOI:10.1002/14651858.CD007223.pub4




How to Cite

Ali, Z. H., & Mohammed, P. R. . (2024). The prevalence of molar pregnancy among patients with incomplete miscarriage at a maternity teaching hospital: GTD associated with incomplete miscarriage. Zanco Journal of Medical Sciences (Zanco J Med Sci), 28(1), 32–40.



Original Articles