OGCO-E3.6 Gestational trophoblastic disease

Question 1

How to make dx of post hydatidiform mole trophoblastic neoplasia (GTN)?

Answer 1

1. GTN may be diagnosed when the plateau of human chorionic gonadotrophin (hCG) lasts for 4 measurements over a period of 3 weeks or longer, that is for days 1,7,14,21.
2. GTN may be diagnosed when there is a rise of hCG of three weekly consecutive measurements or longer, over a period of at least two weeks or more, on days 1,7,14.
3. GTN is diagnosed when there is histologic diagnosis of choriocarcinoma.

Question 2

What is the follow up of GTN?

Answer 2

Regular serum hCG monitoring is important to detect relapse which usually occur within the first 12 months. They should be advised to practise contraception for at least one year before trying to get pregnant again. Various reports show that these patients enjoy normal reproductive function after treatment.

Question 3

What is the FIGO anatomical staging of GTN?

Answer 3

Question 4

What is the prognostic scoring system for GTN?

Answer 4

Question 5

What is the Mx algorithm for GTD and workup Ix?

Answer 5