GONC

Question 1

GTD - incidence and risk

Answer 1

Incidence 1:1000 ish
Partial > complete
Epidemiology/ risks
Higher in Asian population and extremes of age
P0, 2x previous miscarriage
High risk of repeat 1:70 if x1
1:30 if x2

Question 2

Complete mole

Answer 2

20% risk of progression
No maternal DNA therefore p57 neg
46XX (both paternal)

Question 3

Mx of cervical cancer in preg (by stage)

Answer 3

1A1 - Measured stromal invasion
<3 mm in depth. Cone biopsy 14-20/40
1% LN mets. Can have NVD.

1A2 & 1B1
1A2 - stromal invasion ≥3 mm and <5 mm in depth
IB1 - Invasive carcinoma ≥5 mm of stromal invasion and <2 cm in
greatest dimension

General advice <22/40 have a PLND -> if pos then TOP. If neg then consider trachelectomy and cervical cerclage - mixed evidence. 25% PTB.
If pos and wants to cont. or >22/40 then chemo.

1B2 and more -> chemo