GTD Flashcards
GTD consists of
Hydatidiform mole (partial and complete)
Invasive mole
Choriocarcinoma
Placental site trophoblastic tumour
Epithelioid trophoblastic tumour
Atypical placental site nodule
Complete molar pregnancies are
46XX
Anucleic ovum fusing with one sperm (85%) or with two sperm (15%)
Partial molar pregnancies are
Triploid (90%) or tetraploid/mosaic (10%)
Incidence of GTD
1 in 714 births
Incidence of GTN after live birth
1 in 50000
Cure rate in U.K.
98-100%
Chemotherapy rate after partial molar pregnancy
0.5-1%
Chemotherapy rate after complete molar pregnancy
13-16%
Recurrence risk after 1 molar pregnancy
1 in 80
80% same histological type
Recurrence risk after 2 molar pregnancies
1 in 6.5
80% same histological type
Choriocarcinoma metsastatic sites
Lungs (cannon ball mets)
Kidneys
Spleen
GI tract
Brain
Liver
Signs of GTD
Irregular vaginal bleeding
Positive UPT
Sonographic appearance
Enlarged uterus
Hyperemesis
Hyperthyroidism
Early onset PET
Abdominal distension with theca lutein cysts
Haemoptysis
Seizures
Oxytocin is safe?
Not recommended
Cervical preparation prior to SEVAC is safe?
Yes
Follow up for complete mole
6 months if HCG normalises within 56 days
OR
6 months from normalisation of HCG