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Gestational Trophoblastic Disease and Neoplasm

Vanessa Rivera, MD Reviewed 06/2022
 


BASICS

DESCRIPTION

Gestational trophoblastic disease (GTD) is a group of rare conditions associated with pregnancy that consists of abnormal overgrowth of placental trophoblast tissue. Most common cond...

DIAGNOSIS

HISTORY

  • Most common symptom: vaginal bleeding around 6 to 16 weeks, 80–90% of CM, 75% of PM (1)

  • Hyperemesis (8% CM) (1)

  • History of missed or incomplete abortion (90% of patients with PM) (1)

  • ...

TREATMENT

GENERAL MEASURES

  • Suction evacuation and curettage (under US guidance) preferred method for molar pregnancy (2)

  • Obtain serum hCG levels within 48 hours of molar evacuation and every 1-2 weeks ...

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

Ambulatory as tolerated 

Patient Monitoring

  • GTD

    • After hCG normalization, monitor hCG 1 month out for PM, 6 months for CM (2)

    • If hCG positive, must perform pelvic ult...

REFERENCES

1
Brown J, Naumann WR, Seckl M, et al. 15 years of progress in gestation trophoblastic disease: Scoring, standardization, and salvage. Gynecol Oncol. 2017 Jan;144(1):200-207.
2
Ngan H, Seckl M...

CODES

ICD10

  • O01.0 Classical hydatidiform mole

  • O01.1 Incomplete and partial hydatidiform mole

  • O01.9 Hydatidiform mole, unspecified

  • O01 Hydatidiform mole

  • C58 Malignant neoplasm of placenta

  • D39.2 Neoplasm of u...

CLINICAL PEARLS

  • High levels of quantitative HCG levels should arise suspicion for GTD.

  • Pelvic ultrasound preferred modality for evaluation of suspected GTD.

  • FIGO2000 staging and prognostic risk score di...

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