GTD PART 1 and 2

GTD (gestational trophoblastic disease)
A forty years old pregnant woman G4 P3 her LMP was on the 1st of January / 2017 presented with slight vaginal bleeding of 3 days duration, she also complains of nausea and vomiting which is increasing in severity (hyperemesis gravidarum)
O/E: conscious, pale, vitally stable
Abdomen is soft, uterus is soft and 12 weeks in size.
Evacuation was done and during the follow up period the level of hCG was declining well until 8 weeks postevacuation it was noted to rise again over 3 consecutive weeks with attacks of vaginal bleeding and abdominal pain, one week later she developed focal neurological abnormalities for which MRI was done and revealed 3 cm intracranial mass.
Learning objectives:
To clarify the definition, aetiology, risk factors and the classification of GTN
Genetics of H.Mole
Diagnosis of GTN
Principles of management of both benign and malignant varieties
(gestational trophoblastic disease)
It is a spectrum of diseases arises from abnormal fertilization event leading to an abnormal pregnancy
CLASSIFICATION:
1- Benign hydatidiform mole which
further subdivided into partial and
complete mole.
2- Invasive mole (chorioadenoma
destruens) which can metastasize.
3- Choriocarcinoma (frankly malignant).
4- Placental site trophoblastic tumour
(PSTT).
The disease is characterized by the sensitive tumour marker (?-hCG) which is secreted by the tumour cells and allows accurate diagnosis and follow up of the disease.