gestational trophoblastic disease management Flashcards
What is the first-line treatment for complete and partial molar pregnancies?
The first-line treatment for complete and partial molar pregnancies is suction curettage.
When should anti-D prophylaxis be administered in cases of molar pregnancy?
Anti-D prophylaxis should be administered after evacuation of a molar pregnancy.
What should be done 3 weeks after medical treatment of a failed pregnancy if products of conception are not sent for histological examination?
A urine pregnancy test should be performed 3 weeks after medical treatment of a failed pregnancy if products of conception are not sent for histological examination.
Why is histological assessment recommended for material obtained from failed pregnancies?
Histological assessment is recommended to exclude trophoblastic disease.
When is it not necessary to send products of conception for histological assessment after termination of pregnancy (TOP)?
It is not necessary to send products of conception for histological assessment after termination of pregnancy (TOP) if foetal parts have been identified on prior ultrasound.
What follow-up is recommended for patients after evacuation of a molar pregnancy?
Patients should be referred to a trophoblastic screening centre for follow-up, depending on hCG levels at 56 days of the pregnancy event.
When is follow-up for partial molar pregnancy concluded?
Follow-up for partial molar pregnancy is concluded once hCG has returned to normal on 2 samples taken at least 4 weeks apart.
When should patients be urgently referred to a specialist centre in cases of gestational trophoblastic disease?
Urgent referral to a specialist centre is recommended if the uterus is evacuated.
What are the guidelines for future pregnancies after treatment for gestational trophoblastic disease?
Patients should not conceive until follow-up is complete. Barrier contraception is recommended until hCG normalises. COCP can be used once hCG normalises, and IUDs should be avoided until hCG normalises.
What should be recommended to patients regarding conception if they are receiving chemotherapy for gestational trophoblastic disease?
Patients receiving chemotherapy should not conceive for 1 year after completion of treatment and should use effective contraception.
What are the risk factors for gestational trophoblastic disease?
Risk factors include advanced maternal age, being younger than 20, prior molar pregnancy, prior miscarriages, and Asian heritage.
How should the diagnosis of gestational trophoblastic disease be explained to patients?
Explain that gestational trophoblastic disease occurs when the foetus doesn’t form properly, resulting in an irregular mass of pregnancy tissue instead of a baby.
What are the risks associated with gestational trophoblastic disease that should be explained to patients?
Explain that it is important to treat gestational trophoblastic disease because it can invade and damage other tissues.
What is the immediate management for gestational trophoblastic disease?
Immediate management involves suction curettage.
What should be explained about the follow-up process for gestational trophoblastic disease?
Follow-up involves referral to a trophoblastic screening centre to monitor pregnancy hormone levels.
