About Gestational Trophoblastic Disease:

Gestational Trophoblastic Disease (GTD) represents a spectrum of rare clinical and pathologic syndromes related to pregnancy and abnormal placental  development. As such, these usually develop in young women. GTD includes both benign and malignant forms of diseases of trophoblast. Gestational trophoblastic neoplasia (GTN) refers to those entities that  behave in a malignant manner. GTN may occur after an otherwise normal pregnancy or more typically after the occurrence of a non-resolving molar gestation.

Types of GTD:

• partial hydatidiform mole (usually benign)
• complete hydatidiform mole (can be malignant)
• choriocarcinoma (malignant)
• placental site trophoblastic tumors (malignant)
• epithelioid trophoblastic tumors (malignant)

Symptoms:

Molar pregnancy is typically detected in early pregnancy as the result of ultrasound and blood test (b-HCG) measurements performed during early pregnancy care.

• vaginal bleeding
• pelvic pain & cramping
• nausea & vomiting

Diagnosis:

Because of the rare nature of this diagnosis, few physicians have experience in treating this condition. At UHN, we have a dedicated GTD clinic to diagnose and manage women with this diagnosis.

• Complete history & physical exam
• Chest X-Ray or CT scan of chest
• Bloodwork with complete blood panel, electrolytes, liver function tests, b-HCG
• Pelvic ultrasound
• CT abdomen/pelvis
• CT/MRI brain if symptoms

Treatment:

The surgeon may remove GTD with a minor procedure called a dilatation and curettage (D&C).  An expert pathologist will evaluate the tissue removed during surgery to determine the diagnosis. Additional treatment depends on the specific subtype, stage of disease and World Health Organization (WHO) score. Treatment may consist of the D&C alone, or with additional chemotherapy. Post treatment monitoring with regular b-HCG blood tests is necessary to ensure cure. Most women who have had GTD can achieve normal pregnancy after completing treatment.