gynecology and obstetrics
Gestational Trophoblastic Disease
Key Points
Suspect gestational trophoblastic disease during early pregnancy if uterine size is much larger than expected for dates, if beta-hCG levels are unexpectedly high during, if there are symptoms or signs of preeclampsia, or if ultrasonographic findings suggest gestational trophoblastic disease. Measure beta-hCG level, do pelvic ultrasonography, and if findings suggest gestational trophoblastic disease, confirm the diagnosis by pathology evaluation of evacuated uterine contents or endometrial biopsy. Remove the tumor (eg, by suction curettage), then classify the tumor based on clinical criteria. If disease is persistent, treat patients with chemotherapy and prescribe contraception for 12 months. 