Gestational Trophoblastic Disease (GTD)

Why Choose Loyola for Gestational Trophoblastic Disease?

Gestational trophoblastic disease (GTD) is a group of rare tumors that involve abnormal growth of cells inside a woman's uterus during pregnancy.

GTD starts in the layer of cells (the trophoblast) that normally would develop into the placenta. Instead of the formation of a fetus, a tumor forms, which may seem like a normal pregnancy until symptoms are noticeable.

Most GTDs are not cancerous and don't invade deeply into body tissues or spread to other parts of the body, but some can be cancerous.

The different types of GTDs are:

• Hydatidiform moles
• Gestational Trophoblastic Neoplasia (including invasive moles, choriocarcinomas, placental-site trophoblastic tumor and epithelioid trophoblastic tumor

Symptoms and Signs of Gestational Trophoblastic Disease

Talk to your doctor about any abnormal symptoms you experience during your pregnancy, as they can be signs of a GTD. Most GTDs will be found early, however, in a blood test or ultrasound in the first stages of pregnancy.

Symptoms of a GTD include:

• Vaginal bleeding and blood clots, which can indicate a molar pregnancy
• Fatigue and shortness of breath that may indicate anemia
• Swollen abdomen
• Ovarian cysts
• Pre-eclampsia: may indicate a complete molar pregnancy; signs include high blood pressure, swelling in the hands and feet and headaches
• Vomiting
• Hyperthyroidism: may indicate a complete molar pregnancy; signs include high HCG blood levels, mild tremors and rapid heart rate

Causes and Risk Factors of Gestational Trophoblastic Disease

Causes vary depending on the type of GTD you have. In general, the normal process of fertilization and cell division in the uterus that leads to the formation of a fetus does not occur. Instead, a mole, tumor or choriocarcinoma is formed.

Risk factors for GTD include:

• Personal history of a hydatidiform mole
• Being pregnant younger than 20 or older than 35
• Prior miscarriage
• Blood type: Women with A or AB blood types are at a higher risk than women with B or O blood type

How Is Gestational Trophoblastic Disease Diagnosed?

Most cases of GTDs are found early on in the pregnancy during a routine blood or ultrasound test. Additional tests may then be ordered to confirm diagnosis, including:

• Pelvic exam
• Urine or blood test to determine the higher level of human chorionic gonadotropin (HCG), which can be the sign of a complete molar pregnancy
• Ultrasound
• CT Scan
• Chest X-ray
• MRI
• PET Scan

How is Gestational Trophoblastic Disease Treated?

A multidisciplinary team of physicians will help to treat your GTD, including a gynecologist, gynecologic oncologist, radiation oncologist and medial oncologist. The treatment you receive depends on the location, type and extent of the disease.

The most common methods used to treat GTD include:

• Dilation and curettage to remove the tumor
• Chemotherapy
• Hysterectomy to remove the uterus
• Radiation therapy

It is important to talk to your doctor about the best treatment option for you, especially if you desire to become pregnant in the future.

Prevention and Screening for Gestational Trophoblastic Disease

Women who have a family history of molar pregnancies should talk to their doctor about their risks of GTD when planning to become pregnant.

While GTD cannot be prevented, you should get HCG tests and regular prenatal tests if you are at risk. Most cases of GTD are completely treatable, even if they are not found in the earliest stages.