Chapter 208 Gestational Trophoblastic Disease
INTRODUCTION
Description: Gestational trophoblastic diseases include choriocarcinoma, molar pregnancy (hydatidiform mole and invasive mole), and placental-site trophoblastic tumor. They are abnormalities of pregnancy that arise entirely from abnormal placental proliferation. They are classified as being either complete, in which no fetus is present, or incomplete (partial), in which both fetus (generally abnormal) and molar tissues are present.
Prevalence: Molar pregnancy—1 of 1000 to 1500 pregnancies in the United States, as high as 10 per 1000 pregnancies in Asia; choriocarcinoma—1 of 40,000 pregnancies.
CLINICAL CHARACTERISTICS
Signs and Symptoms
• Present as a pregnancy but associated with more profound hormonal changes, leading to exaggerated symptoms of pregnancy in many patients
• Hypertension, pre-eclampsia, proteinuria, nausea and vomiting (hyperemesis, 8%), visual changes, tachycardia, and shortness of breath all possible (pregnancy-induced hypertension in the first trimester of pregnancy is virtually diagnostic)
