20) Gestational Trophoblastic Disease (GTD)

Question 1

What is the Definition of “Gestation Trophoblastic Disease”?

Answer 1

• It’s when there’s Proliferative ABNORMALITIES of the TROPHOBLAST of Placenta

Question 2

What are the Types of Gestation Trophoblastic Disease?

Answer 2

1) Hydatidiform Mole (Molar Pregnancy) - BENIGN

2) Invasive Mole MALIGNANT

3) Choriocarcinoma MALIGNANT

Question 3

What is Hydatidiform Mole (Molar Pregnancy)?

Answer 3

• It’s BENIGN Tumor of Uterus due to ABNORMAL FERTILISATION of OVUM

1) COMPLETE - NO Fetal / Embryonic Bits

• Due to Fertilisation of EMPTY Egg, by a sperm WHICH DUPLICATES from having Previous Molar Pregnancy, or Younger than 15 ; Older than 35
• CFs = Vaginal Bleeding in 1st Trim, LARGER Uterus, INCREASED B-hCG, Preeclampsia, Hyperemesis Gravidarum
• Tx = Dilation + Curettage

2) PARTIAL - SOME Fetal / Embryonic Bits

• Due to Fertilisation of Egg WITH 2 SPERMS
• CFs = Vaginal Bleeding in 1st Trim, and Pelvic Pain
• Tx = Dilation + Curettage

Question 4

What is INVASION Mole?

Answer 4

• When Hydatidiform Mole PENETRATES –> MYOMETRIUM
• Causing Vaginal Bleeding + INCREASED B-hCG
• Tx = Chemotherapy Methotrexate

Question 5

What is CHORIOCARCINOMA?

Answer 5

• HIGHLY MALIGNANT Form of Gestational Trophoblastic Disease
• Develop FROM Hydatidiform Mole, Ectopic Pregnancy or Miscarriage
• It INVADES the MYOMETRIUM + METASTASISES to Distant Organs

CFs = Post-Partum Bleeding, Symptoms related to METASTASIS (Dyspnoea, Hemoptysis)

Diagnosis = Mass on Ultrasound; Chest X-Ray shows Cannonball Metastasis in Lungs

Tx = Chemotherapy *(Methotrexate) or Hysterectomy