Gestational Trophoblastic Disease

Answers to all your questions about GTD.
ByDeborah Ottenheimer, MD
March 2, 2017
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What is gestational trophoblastic disease?

Gestational trophoblastic disease (GTD) is a spectrum of rare tumors that arise from the cells that would typically develop into a pregnancy.

Important note: GTD involves tumors, but not all tumors are cancerous. In fact, the most common form of GTD, the hydatidiform mole (sometimes called a “ molar pregnancy”), is benign.

What are the signs of GTD?

A woman with GTD typically misses her period, gets a positive pregnancy test and believes she’s carrying a normal pregnancy — until unusual  symptoms (including abnormal bleeding and a uterus that measures larger than expected) and/or further testing reveal the presence of GTD and the absence of a viable pregnancy.

Are there any tests for GTD?

Blood tests and ultrasounds are usually used to diagnose GTD. Your doc will track your HCG level via blood tests. HCG is the hormone picked up by pregnancy tests, but in GTD, it usually rises faster than normal. An ultrasound may reveal a uterus filled with grape-like clusters, the hallmark of a molar pregnancy. A normally developing fetus is not visible.

How common is GTD?

Molar pregnancies are rare: they range from 23 to 1,299 cases per 100,000 pregnancies. Other forms of GTD are even more rare.

How did I get GTD?

A complete molar pregnancy occurs when one or two sperm cells fertilize an egg without a nucleus. (No one seems to know why some eggs are nucleus-free.) A partial molar pregnancy occurs when two sperm cells fertilize one egg.

How will my GTD affect my baby?

We’re really sorry, but there’s no baby. GTD means something has gone seriously wrong with the pregnancy, and it’s not viable. The good news is, most women with GTD have a successful pregnancy in the future (see next page for treatment and resources).

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What’s the best way to treat GTD?

Most cases of GTD are easily treated with surgery. Sometimes, though, a woman experiences persistent trophoblastic disease, which means that evidence of the disease remains after surgery. In those cases, treatment with chemotherapy drugs may be necessary.

What can I do to prevent GTD?

Since the GTD is such a mystery, there’s no known prevention.

What do other women do when they have GTD?

“I had a complete molar pregnancy diagnosed this past March, which has since evolved into GTN (Gestational Trophoblastic Disease), which is cancerous. I am undergoing chemo right now for treatment. It is highly curable, but you do have to wait a while to TTC to make sure you don’t have a recurrence. I will likely have to wait six months to TTC once chemo is finished.”

“Due to the molar turning into Gestational Trophoblastic Disease, I can’t TTC until [eight months from now] at the latest.”

Are there any other resources for GTD?

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