Epidemiology, Histopathologic Patterns, and Clinical Characteristics of Gestational Trophoblastic Diseases in Ethiopia: A Systematic Review and Meta-Analysis Study.

Background: Gestational trophoblastic diseases (GTDs) are rare trophoblastic disorders that contribute substantially to maternal morbidity. However, the epidemiology and clinical characteristics of GTD-related evidence from Ethiopia remain limited and scattered. Consequently, the national burden, histopathological distribution, and clinical presentation of GTD in Ethiopia are not well defined. In response to this gap in the literature, this systematic review and meta-analysis sought to quantify the pooled prevalence of GTD and to synthesize available evidence on its histopathological and clinical profiles in Ethiopia. Methods: PubMed, Scopus, Embase, the Cochrane Library, CINAHL, and Google Scholar were systematically searched, supplemented by manual searches of local journals and institutional repositories. The study protocol was registered and implemented in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 guidelines. All studies reporting the prevalence of GTD in Ethiopia up to December 5, 2025, were eligible for inclusion. To stabilize variances when pooling proportions, a random-effects meta-analysis was performed by using the Freeman-Tukey double arcsine transformation. Publication bias and heterogeneity across studies were evaluated. Results: Seven studies met the inclusion criteria, out of a total of 436 records collected and evaluated, comprising 121,248 women who had delivered. The pooled prevalence of GTD in Ethiopia was 0.8% (95% CI: 0.2%-1.3%). Hydatidiform mole was the most common histopathological subtype, with complete and partial moles accounting for 47.1% and 20.7% of cases, respectively. Vaginal bleeding was the most frequently reported clinical presentation (88.4%), followed by a uterus larger than gestational age (34.8%). Conclusions: This systematic review and meta-analysis demonstrated that the prevalence of GTD in Ethiopia is slightly higher than estimates reported from other regions. Hydatidiform mole was the predominant histopathological subtype, and vaginal bleeding was the most common clinical presentation. These results highlight the necessity of enhancing early detection and diagnostic capacity, particularly at the primary healthcare level.