Gestational Trophoblastic Disease: The Basics

Gestational Trophoblastic Disease (GTD) is when tumor(s) form in the uterus during pregnancy. These tumors are made up of trophoblast cells. Trophoblasts are cells that are made during the first stage of pregnancy. They provide nutrients for the embryo and become part of the placenta. The tumors can be cancerous (malignant) or non-cancerous (benign). Another name for GTD is Gestational Trophoblastic Neoplasia (GTN).

Risk Factors

Your risk for GTD may be higher if you:

• Had GTD during a prior pregnancy.
• Are pregnant and younger than 20 years old or older than 35 years old.

Signs and Symptoms of GTD

The signs of GTD can be the same as the signs of a miscarriage (the loss of a pregnancy). There also may be no signs and it may seem to be a normal pregnancy.

Some of the symptoms of GTD during pregnancy are:

• Vaginal bleeding.
• Feeling pain in your pelvis or around it.
• A uterus that is bigger than it should be.
• High blood pressure.
• Low red blood cell count (anemia).

Diagnosis

If you or your provider thinks you have GTD, they will look at your health history and check your pelvis. They may also do an ultrasound, test your blood and urine, and check for levels of certain tumor markers.

Staging

If GTD is cancerous, you will need treatment. To plan treatment, the tumor is given a stage and a score. The stages of the tumor are 1 to 4 (I to IV). Stage 1 means the disease is only in the uterus and stage 4 means the tumor has spread (metastasized).

The score helps figure out your overall risk and which treatment may be best. The score is a number given based on certain factors, such as:

• Your age.
• Previous pregnancy.
• The amount of hCG (human chorionic gonadotropin) before treatment starts. hCG is a hormone in your blood that tells when a woman is pregnant.
• If and where the tumor has spread.
• If there have been medications used to treat the tumor that have not worked.

Treatment

GTD is often treated with surgery which helps find, stage, and remove as much of the tumor as possible. Some of the common types of surgery are:

• Suction dilation and curettage (also called a “D and C”).
• Hysterectomy.

Chemotherapy may also be used to kill cancer cells.

This article is a basic guide to GTD. You can learn more about GTD by visiting:

Surgical Procedures: Surgery and Staging for Gestational Trophoblastic Neoplasia (GTN)