Gestational trophoblastic disorders

Question 1

what is it

Answer 1

Describes a spectrum of disorders originating from the placental trophoblas

Question 2

examples of disorders originating from the placental trophoblasts

Answer 2

complete hydatidiform mole
partial hydatidiform mole
choriocarcinoma

Question 3

what is complete hydatidiform mole

Answer 3

Benign tumour of trophoblastic material.

Occurs when an empty egg is fertilized by a single sperm that then duplicates its own DNA, hence the all 46 chromosomes are of paternal origin

Question 4

features

Answer 4

bleeding in first or early second trimester

exaggerated symptoms of pregnancy e.g. hyperemesis

uterus large for dates

very high serum levels of human chorionic gonadotropin (hCG)

hypertension and hyperthyroidism* may be seen

Question 5

Mx

Answer 5

urgent referral to specialist centre - evacuation of the uterus is performed

effective contraception is recommended to avoid pregnancy in the next 12 months

Question 6

what is a partial mole?

Answer 6

a normal haploid egg may be fertilized by two sperms, or by one sperm with duplication of the paternal chromosomes.

Therefore the DNA is both maternal and paternal in origin.

Usually triploid - e.g. 69 XXX or 69 XXY. Fetal parts may be seen

Question 7

what can HCG mimic?

Answer 7

TSH