Gestational Trophoblastic Disease

Question 1

Gestational Trophoblastic Disease
Benign chromosomal numbers
1. Partial
2. Complete

Answer 1

Partial 69XXY
Complete 46XX

Question 2

GTD Malignant types

Answer 2

Choricocarcinoma
Invasive Mole
PSTT
ETT

Question 3

GOD incidence

Answer 3

1/714 live birth

Question 4

GTD complete Mole key info

Answer 4

Diploid of single sperm
Empty ovum
No evidence of fetal tissue
75-80% duplicate single sperm
20-25% dis sperm
46XX
More chance of choriocarcinoma

Question 5

GTD partial Mole key info

Answer 5

Normal haploid egg fertilized >2 sperms
90% Tripploid
10% Tetraploid
All are dispermic fertilization
Has Fetal tissue and Fetal RBC
69XXY

Question 6

Choriocarcinoma incidence rate

Answer 6

1/50,000 pregnancies

Question 7

Incidence after TOP with GTD

Answer 7

1/20,000

Question 8

GTD most common symptom

Answer 8

Vaginal bleeding

Question 9

Classic GTD symptoms

Answer 9

Irregular pv bleeding
Hypermesis
Excessive uterine enlargement
Early failed pregnancy

Question 10

GTD pre evauction diagnosis

Answer 10

TVS

Question 11

GTD best/ gold standard or definitive diagnosis

Answer 11

Histopathology

Question 12

Investigation prognostic for GTD

Answer 12

BHCG

Question 13

Difference b/w partial and Complete by

Answer 13

Immunohistochemistry p57

Question 14

P57 +ve in

Answer 14

Partial Mole

Question 15

Method of choice for removal of complete Molar pregnancy

Answer 15

Ultrasound guided Suction curettage - 2020 Guidelines

Question 16

AntiD prophylaxis recommended

Answer 16

Yes following Molar pregnancy partial mole

Question 17

Parial Mole in USG ( every case) anti D

Answer 17

YES

Question 18

Complete mole In Histopathology Anti D indicate

Answer 18

No

Question 19

Complete mole in USG What we give

Answer 19

Give anti D

Question 20

Case: Treatment P Mole at 9 weeks or <15 weeks

Answer 20

Suction and curettage

Question 21

Treatment Partial Mole >15 weeks

Answer 21

Medical evauction then Suction & curettage

Question 22

Treatment Complete Mole treatment

Answer 22

Suction and curettage

Question 23

Use of Oxytocin in GTD

Answer 23

Not recommend

Question 24

Care of Miscarriage

Answer 24

Urine for pregnancy test 3 weeks

Question 25

If GTD complete Molar pregnancy followup
HCG revert normal within 56 days

Answer 25

For 6 months from the date of Uterine removal

Question 26

If GTD complete Molar pregnancy followup
HCG not revert to normal within 56 days

Answer 26

For 6 months from the date of normalization of HCG

Question 27

Partial Molar pregnancy followup

Answer 27

Two sample of HCG gap at least 4 weeks apart

Question 28

Need BHCG for subsequent pregnancy

Answer 28

Chemotherapy case No need

Question 29

GT Neoplasia treatment based on

Answer 29

FIGO 2000 scoring

Question 30

When to get pregnancy after molar pregnancy with Chemotherapy

Answer 30

2 year

Question 31

Recurrence of molat pregnancy

Answer 31

After 1 mole 1 in 80
After 2 mole 2 in 6
After 3 mole 1 in 2

Question 32

Chemotherapy scoring criteria

Answer 32

Score `< 6 low risk
Score > 7 high risk

Question 33

GTD low risk Chemotherapy

Answer 33

Single im methotrexate alternating
Folinic acid
For 1 week followed by 6 rest day

Question 34

High risk GTD Chemotherapy

Answer 34

IV multiple agents
Methotrexate
Dactinomycin
Etoposide
Cylcophosphamide
Vincristine

Question 35

Long term outcome of Chemotherapy with GTD for Menopause

Answer 35

Single dose - Menopause by 2 year
Multiple dose - Menopause by 3 year

Question 36

Figo scoring

Answer 36

Review

Question 37

GTD Contraceptive method

Answer 37

Barrier method