Gestational Trophoblastic Disease

Question No. 9. The Answer is: (A) Low social-economical status.

Discussion: Unlike other lesions in gestational trophoblastic disease, the epidemiology of molar pregnancy is well studied and documented. In general, the incidence is higher in Asia, South America and Africa, and lower in North America, Europe and Australia. While low socio-economic class is often linked to other known associated risk factors, it is generally described in association with a higher incidence of molar pregnancy. Other known factors associated with an increased incidence include previous molar pregnancy (each successive molar pregnancy further increases subsequent risk) and gestations in mothers under 20 years and over 40 years old. A history of normal term pregnancy is associated with a decreased risk. The number of gestations or multiparity in general, however is not associated with an increased risk. Despite its link to cardiovascular disease and colon cancer, high fat diets have not been clearly associated with an increased risk of molar pregnancy. HPV is directly linked to the pathogenesis of cervical cancer, but as yet has no direct role in the formation of hydatifrom moles.

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