GESTATIONAL TROPHOBLASTIC DISEASE

Early pregnancy problems:- (Continued)
1- Abortion
2- Ectopic pregnancy
3- Gestational trophoblastic disease
or neoplasia (GTN).

GTN (gestational trophoblastic neoplasia)

Learning objectives:
? To clarify the definition, aetiology, risk factors and the classification of GTN
? Genetics of H.Mole
? Diagnosis of GTN
? Principles of management of both benign and malignant varieties


References: Essentials of Obstetrics and gynecology (5th ed), Gynecology by ten teachers (18th ed),

GTN (gestational trophoblastic neoplasia)
It is a spectrum of diseases arises from abnormal fertilization event.

Classification:
1- Benign hydatidiform mole which further subdivided into partial and complete mole.
2- Invasive mole (chorioadenoma destruens) which can metastasize.
3- Choriocarcinoma (frankly malignant).
4- Placental site trophoblastic tumour (PSTT).

*The majority of the patients follow a benign course 80-90% and their disease remitting spontaneously.

**The disease is characterized by the sensitive tumour marker (?-hCG) which is secreted by the tumour cells and allows accurate follow up of the disease.

***( HIGH INDEX OF SUSPECION) So any woman with molar pregnancy, normal pregnancy or abortion who is presented with bleeding or a tumour should have at least one (?-hCG) assay. To exclude GTN.