Management of Gestational Trophoblastic Disease: Case Presentations and Outcomes of Management at Mbingo Baptist Hospital, Cameroon

Introduction. Mbingo Hospital, Cameroon sees a high proportion of women presenting with high risk gestational trophoblastic neoplasia (GTN). GTN is highly curable with appropriate diagnosis and treatment. The first objective of our study is to present two cases of women with Gestational Trophoblastic Disease (GTD) who attended Mbingo Baptist Hospital (MBH) and the second objective to more formally assess the outcomes of women with GTN. Methodology. This was a retrospective cohort study from 2011 to 2024 on all medical records of patients with GTN at Mbingo Baptist Hospital. Results. From 2011 to 2024, 57 women presented with an elevated βHCG and were diagnosed as low risk (WHO score <6) or high risk (WHO score ≥7). Mean age was 31.6 years old (range 19-53). The most common regimen for Low Risk (LR) disease was the 8 day alternating Methotrexate-Folinic Acid (19/32). Those not treated on this regimen generally were usually referred from other centers. The most common regimen for High Risk (HR) disease was EMACO (18/25). Five HR women went on to TPTE. Fifteen women had a hysterectomy. Some of the quality improvement issues we identified related to patient (ie., competing demands), hospital (ie., geographic location), providers (ie., lack of knowledge), national health care system (ie., lack of universal health care system, care pathways, protocols). Conclusion. GTN is a disease of young women and is very curable with appropriate diagnosis, treatment and follow-up. Governments need to consider including the costs for diagnosis and management of GTN within a universal health care package.