Gestational Trophoblastic Disease refers to a group of rare and abnormal growths that develop during abnormal pregnancy. Though it is uncommon, understanding it is important. It is noteworthy that some GTDs are noncancerous while others are Malignant. This article discusses the types, causes, treatment, and symptoms of gestational trophoblastic disease 

The Types of GTD

• Hydatidiform Mole (molar pregnancy): This is the most common form of GTD. It is usually the result of abnormal fertilization of eggs. It results in a mass of cysts. There are two types: partial mole and complete mole.
• Gestational Trophoblastic Neoplasia (GTN): This is a more serious form and can occur after a molar pregnancy. It includes several Malignant growths, such as Invasive moles (invade the uterine wall), Choriocarcinoma (spreads quickly to other parts), placental-site Trophoblastic tumor (forms at the placenta), and Epithelioid trophoblastic tumor (a rare and slow-growing tumor).

The Causes

Several factors contribute to increasing the risk of developing GTD.

• Abnormal fertilization: If an empty egg or multiple sperms fertilize the egg, it may lead to abnormal trophoblastic tissues.
• Maternal age: Women who are under age 20 or above 40 are at risk of developing GTD
• Previous Molar pregnancy: Having a history of molar pregnancy increases the risk of developing another one.

The Symptoms

The symptoms may vary and are dependent on the type and how severe. Common symptoms, however, include:

• Vaginally bleeding: Abnormal vaginal bleeding during pregnancy is one of the most common signs of GTD. It may be spotting or heavy bleeding, and the bleeding may be mistaken for a miscarriage.
• Severe Nausea and Vomiting: Most women with GTD would experience severe morning sickness. This is usually more serious than that of pregnancy nausea.
• Uterine Growth: GTD makes the uterus grow faster than expected fir the stage of pregnancy. This results from the abnormal growth of trophoblastic tissues and may be detected through a physical examination or ultrasound.
• High hCG level: Human Chorionic Gonadotropin(hCG)is a hormone produced during pregnancy. With GTD, the levels would be much higher. It can be confirmed through blood tests and is one major factor used to diagnose the condition
• Pre-eclampsia: Women with GTd may show signs of preeclampsia, like high blood pressure and protein in the urine in the first trimester.

The Treatment

Gestational Trophoblastic Disease treatment depends on the type, the stage it is at when diagnosed, and whether it is benign (not harmful) or Malignant. Treatment is to remove or destroy abnormal trophoblastic tissue, monitor for signs of recurrence, and preserve fertility whenever possible.

Specific treatment methods are:

• Suction Curettage: This is most suitable for molar pregnancy. Abnormal tissue is removed from the uterus using a gentle suction device.
• Chemotherapy: This is more suitable for invasive moles, choriocarcinoma, and other Malignant forms.
• Hysterectomy: This is the removal of the uterus. However, it is not favored by women who would still love to give birth.
• Radiation Therapy: In extremely rare cases, if it has spread to the brain or lungs, surgery isn’t possible, and radiation therapy would be suggested to help target the cancerous cells. This is, however, a thing of last resort where chemotherapy and surgery will not suffice.

Conclusion

Although rare, Gestational Trophoblastic Disease can have serious implications if not treated. However, with early detection, treatment, and follow-up, most women make a full recovery.

Knowing the symptoms and risks of GTD is crucial for ensuring that women seek timely medical attention, leading to better health outcomes and fertility prospects. To get the best female gynaecologist and laparoscopic surgeon in Mumbai, Connect with Dr Neelima Mantri.