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Chapter 10 - Gestational Trophoblastic Disease (GTD)

Published online by Cambridge University Press:  14 July 2023

Swati Jha
Affiliation:
Sheffield Teaching Hospital NHS Foundation Trust
Priya Madhuvrata
Affiliation:
Sheffield Teaching Hospital NHS Foundation Trust
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Summary

Gestational trophoblastic disease (GTD) incorporates a spectrum of placental related disorders, with both benign and malignant (Gestational trophoblastic neoplasia (GTN)) subtypes. Upon initial presentation, one should establish diagnosis (GTD versus GTN), the requirement for chemotherapy and whether monitoring has been concluded by a specialist trophoblastic centre. Women with a prior history of GTD or GTN that have completed monitoring, or early pregnant GTD patients, do not require specialist pregnancy management. Dissimilarly, early pregnant GTN patients, particularly those treated for high-risk disease, or women with a twin pregnancy involving a complete hydatidiform mole and viable co-existent foetus should receive detailed antenatal counselling and be managed under consultant-led care. Patients with a twin mole and viable co-existent foetus have a high risk of antenatal, intrapartum and post-partum complications. Fortunately, in women with a prior history of trophoblastic disease, live birth rates equal the general population, with no increased risk of disease relapse.

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Publisher: Cambridge University Press
Print publication year: 2023

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