gynecology and obstetrics
Gestational Trophoblastic Disease
Symptoms and Signs of Gestational Trophoblastic Disease
Initial manifestations of a hydatidiform mole suggest early pregnancy, but the uterus often becomes larger than expected within 10 to 16 weeks gestation. Commonly, women test positive for pregnancy and have vaginal bleeding and severe nausea and vomiting ( Hyperemesis Gravidarum ) and fetal movement and fetal heart sounds are absent. Vaginal passage of grapelike tissue strongly suggests the diagnosis. Complications, such as the following, may occur: Severe bleeding, with possible Hypovolemic shock None Preeclampsia and Eclampsia None Ovarian theca lutein cysts Less common complications include Postpartum Endometritis and Placental site trophoblastic tumors tend to cause bleeding. Choriocarcinoma usually manifests with symptoms due to lung, liver, or brain metastases. Hyperthyroidism is more common among women with gestational trophoblastic disease than in those without. Symptoms can include tachycardia, warm skin, sweating, heat intolerance, and mild tremors. Gestational trophoblastic disease does not impair subsequent fertility or predispose to prenatal or perinatal complications (eg, congenital malformations, spontaneous abortions) in subsequent pregnancies. 