Gestational trophoblastic disease

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Gestational trophoblastic disease
File:Intermediate trophoblast 3 - low mag.jpg
Synonyms	N/A
Pronounce	N/A
Specialty	N/A
Symptoms	Vaginal bleeding, pelvic pain, hyperemesis gravidarum
Complications	Metastasis, hemorrhage, preeclampsia
Onset	During or after pregnancy
Duration	Varies
Types	Hydatidiform mole, Invasive mole, Choriocarcinoma, Placental site trophoblastic tumor
Causes	Abnormal fertilization
Risks	Advanced maternal age, previous molar pregnancy
Diagnosis	Ultrasound, hCG levels, histopathology
Differential diagnosis	Ectopic pregnancy, miscarriage, normal pregnancy
Prevention	None
Treatment	Dilation and curettage, chemotherapy, hysterectomy
Medication	Methotrexate, dactinomycin
Prognosis	Generally good with treatment
Frequency	1 in 1,000 pregnancies
Deaths	N/A

Gestational trophoblastic disease (GTD) is a group of rare tumors that involve abnormal growth of cells inside a woman's uterus. These tumors start in the cells that would normally develop into the placenta during pregnancy. GTD is a spectrum of diseases that includes hydatidiform mole (also known as a molar pregnancy), invasive mole, choriocarcinoma, and placental-site trophoblastic tumor.

Types of Gestational Trophoblastic Disease

GTD encompasses several different conditions, each with unique characteristics:

• Hydatidiform Mole: This is the most common form of GTD and can be classified as either a complete mole or a partial mole. A complete mole occurs when an egg with no genetic information is fertilized by a sperm, leading to the growth of abnormal tissue. A partial mole occurs when an egg is fertilized by two sperm, resulting in an abnormal fetus and placenta.
• Invasive Mole: This type of mole can penetrate the muscular layer of the uterus and may cause significant bleeding. It is a locally invasive form of GTD.
• Choriocarcinoma: A highly malignant form of GTD that can spread to other parts of the body, including the lungs, liver, and brain. It often follows a molar pregnancy but can also occur after a normal pregnancy, miscarriage, or abortion.
• Placental-Site Trophoblastic Tumor: A rare form of GTD that arises from the placental implantation site. It tends to grow more slowly and is less likely to spread than choriocarcinoma.

Symptoms

The symptoms of GTD can vary depending on the type and extent of the disease. Common symptoms include:

• Abnormal vaginal bleeding during or after pregnancy
• Severe nausea and vomiting
• Rapidly enlarging uterus
• High levels of human chorionic gonadotropin (hCG) in the blood
• Absence of fetal heart sounds in the case of a molar pregnancy

Diagnosis

Diagnosis of GTD typically involves a combination of:

• Ultrasound: To visualize the abnormal growth in the uterus.
• Blood tests: To measure levels of hCG, which are usually elevated in GTD.
• Histopathology: Examination of tissue samples under a microscope to confirm the diagnosis.

Treatment

Treatment for GTD depends on the type and stage of the disease. Common treatment options include:

• Dilation and curettage (D&C): A surgical procedure to remove abnormal tissue from the uterus.
• Chemotherapy: Often used for more aggressive forms of GTD, such as choriocarcinoma.
• Hysterectomy: Surgical removal of the uterus, which may be necessary in some cases.

Prognosis

The prognosis for GTD is generally good, especially when diagnosed early and treated appropriately. Most women with GTD can be cured, and fertility is often preserved. However, follow-up care is essential to monitor for any recurrence of the disease.

See Also

• Pregnancy
• Placenta
• Oncology
• Gynecology

External Links

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