Module 8 (Exam 3) Gestational Trophoblastic Disease

Question 1

Gestational Trophoblastic Disease (Hydatidiform Mole)

Answer 1

Trophoblasts develop abnormally and the blastocyst dies. Chorionic villi swell and form grapelike clusters of tissues that grow rapidly and fill the uterus.

Question 2

Signs and Symptoms of Gestational Trophoblastic Disease

Answer 2

1. Positive pregancy test
2. hcg levels higher than expected for gestation
3. Uterus larger than gestational age
4. Vaginal bleeding - from dark brown spotting to hemorrhage
5. Excessive nausea and vomiting (hyperemesis gravidarum)

Question 3

Therapeutic Management of Gestational Trophoblastic Disease

Answer 3

1. Confirm pregnancy
2. Ultrasound snowstorm pattern and no fetus
3. Elevated hCG levels
4. Monitor bleeding
5. Treat symptoms of HEG or pre-eclampsia
6. Evacuate trophoblastic tissue
7. Screen for metastatic disease
8. Follow up: serial hCG levels for one year, pregnancy preventation for one year, screen for malignancy

Question 4

Define hydatidiform mole

Answer 4

Abnormal growth of trophoblastic tissue

Question 5

Discuss the rationale for monthly hCG testing for one year following the diagnosis of GTD

Answer 5

Alerts to cancer. If cancer is to form, it will present within 1 year’s time.