Benign Gestational Trophoblastic Disease (GTD) Flashcards
(28 cards)
What is gestational trophoblastic disease (GTD)?
A spectrum of interrelated tumours due to abnormal proliferation of trophoblastic tissue.
What are the components of trophoblastic tissue?
Cytotrophoblast, syncytiotrophoblast, and intermediate trophoblast.
What are the types/classifications of GTD?
Benign: Hydatidiform mole; Malignant: Invasive mole, choriocarcinoma, PSTT.
What are the types of hydatidiform mole?
Complete mole and partial mole.
What is a hydatidiform mole?
Neoplastic proliferation of trophoblast with terminal villi transformed into fluid-filled vesicles.
What is the worldwide incidence of hydatidiform mole?
0.5–2.5 per 1000 pregnancies.
What is the incidence of H. mole in Nigeria?
3.6 per 1000 pregnancies.
What percentage of H. moles become invasive?
16% become invasive; 2.5% progress to choriocarcinoma.
What are the risk factors for molar pregnancy?
<15 or >35 years, previous mole, blood type A, low protein/carotene, low SES, high parity, cytogenetic abnormalities.
What causes a complete mole?
Fertilisation of an empty ovum by one sperm (duplicated) or two sperms.
What is the most common karyotype in a complete mole?
46XX (90%), 46XY (10%).
What causes a partial mole?
Fertilisation of a normal ovum by two sperms.
What is the common karyotype in a partial mole?
69XXX, 69XXY, or 69XYY.
List four features of a complete mole.
46XX/XY, no foetal parts, large uterus, theca lutein cysts (30%), diffuse trophoblastic hyperplasia.
List four features of a partial mole.
69XXX/XXY, foetal parts present, smaller uterus, focal trophoblastic hyperplasia, few/no cysts.
List common clinical features of molar gestation.
Amenorrhoea, vaginal bleeding, abdominal pain, exaggerated pregnancy symptoms, theca lutein cysts, early PIH, hyperthyroidism, large doughy uterus.
What is the role of β-hCG in diagnosis?
β-hCG is markedly elevated and helps confirm diagnosis.
What are the ultrasonographic findings in a complete mole?
“Snowstorm” appearance due to diffuse swelling of chorionic villi.
What are the ultrasonographic findings in a partial mole?
Focal cystic spaces in placenta, enlarged gestational sac.
What investigations are done in molar pregnancy?
Quantitative β-hCG, FBC, LFTs, RFTs, TFTs, ultrasound, CXR.
What is the treatment for hydatidiform mole?
Suction evacuation + supportive care (e.g., anti-D for Rh-neg mothers).
What is the follow-up protocol after evacuation?
Weekly β-hCG until 3 consecutive undetectable values, then monthly for 6 months.
Why is contraception recommended post-evacuation?
Pregnancy delays detection of recurrence and increases risk.
What contraception methods are recommended?
Barrier methods (ideal), COCs (acceptable), avoid IUCDs.
