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Link to original content: https://pubmed.ncbi.nlm.nih.gov/33416290
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Review
. 2021 Feb 1;137(2):355-370.
doi: 10.1097/AOG.0000000000004240.

Gestational Trophoblastic Disease: Current Evaluation and Management

John T Soper  1
Affiliations
Review

Gestational Trophoblastic Disease: Current Evaluation and Management

John T Soper. Obstet Gynecol. .

Erratum in

Abstract

This review summarizes the current evaluation and management of gestational trophoblastic disease, including evacuation of hydatidiform moles, surveillance after evacuation of hydatidiform mole and the diagnosis and management of gestational trophoblastic neoplasia. Most women with gestational trophoblastic disease can be successfully managed with preservation of reproductive function. It is important to manage molar pregnancies properly to minimize acute complications and to identify gestational trophoblastic neoplasia promptly. Current International Federation of Gynecology and Obstetrics guidelines for making the diagnosis and staging of gestational trophoblastic neoplasia allow uniformity for reporting results of treatment. It is important to individualize treatment based on their risk factors, using less toxic therapy for patients with low-risk disease and aggressive multiagent therapy for patients with high-risk disease. Patients with gestational trophoblastic neoplasia should be managed in consultation with an individual experienced in the complex, multimodality treatment of these patients.

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Conflict of interest statement

Financial Disclosure The author did not report any potential conflicts of interest.

Figures

Fig. 1.
Fig. 1.. Low-power photomicrograph of complete hydatidiform mole demonstrates markedly edematous avascular hydropic villi with sheets of trophoblastic cells at the periphery (arrows). Hematoxylin-eosin stain, ×40 magnification. Image courtesy of Dr. Siobhan M. O’Connor. Used with permission.
Soper. Gestational Trophoblastic Disease. Obstet Gynecol 2021.
Fig. 2.
Fig. 2.. Low-power photomicrograph of partial hydatidiform mole: decidualized endometrium is in the upper field (*), with characteristic villi centrally (†). In contrast to complete moles, there is variable edema of the villi, with scalloping at the edges and trophoblastic inclusions (arrows) within villi. Trophoblastic proliferation is less pronounced and focal compared with complete moles. Image courtesy of Dr. Rex Bentley. Used with permission.
Soper. Gestational Trophoblastic Disease. Obstet Gynecol 2021.
Fig. 3.
Fig. 3.. Ultrasonogram of an unevacuated complete mole demonstrates intrauterine tissue with a mixed echogenic pattern.
Soper. Gestational Trophoblastic Disease. Obstet Gynecol 2021.
Fig. 4.
Fig. 4.. In this gross photograph of an invasive complete mole treated with hysterectomy, the hydropic villi make up the majority of the mole (black arrow). A focus of myometrial invasion is present in the myometrium to the right of the large intrauterine tumor (blue arrow).
Soper. Gestational Trophoblastic Disease. Obstet Gynecol 2021.
Fig. 5.
Fig. 5.. This high-power photomicrograph of gestational choriocarcinoma demonstrates the multinucleated syncytiotrophoblast (black arrow) and polygonal cytotrophoblast cell populations (white arrow). Hematoxylin-eosin stain, ×40 magnification. Image courtesy of Dr. Siobhan M. O’Connor. Used with permission.
Soper. Gestational Trophoblastic Disease. Obstet Gynecol 2021.
Figure
Figure
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