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University of Lynchburg Doctoral Project Assignment Repository

Abstract

ABSTRACT

Gestational trophoblastic disease (GTD) is a rare group of pregnancy-related conditions that includes premalignant and malignant disease. These include partial and complete hydatidiform mole, choriocarcinoma, epithelioid trophoblastic tumor, and placental site trophoblastic tumor.1 Synthesizing 15 peer-reviewed articles from the preceding five years, this review will provide an update on the epidemiology, clinical presentation, diagnosis, and treatment of GTD. The estimated global incidence of molar pregnancy ranges from 1:1000 to 1:1500 pregnancies.2 The most common type of GTD is hydatidiform mole, which carries a 15-20% risk of progression to gestational trophoblastic neoplasia.  Regardless of the type of GTD, the overall risk of developing distant metastatic disease is 20-30%.2 Although the incidence remains relatively low, clinical vigilance is required; therefore, this condition should be included in the differential diagnoses for reproductive-aged females. Accurate diagnosis includes recognizing the symptoms, interpreting human chorionic gonadotropin (hCG) levels, assessing ultrasound findings, and evaluating histopathology to differentiate complete and partial hydatidiform moles. The literature demonstrates that psychosocial and access barriers should be addressed as part of the clinical management. Emerging evidence supports shortened hCG surveillance protocols following normalization in partial molar pregnancies, though standardized guidelines require further validation.2-5 Ultimately, overcoming access barriers and maintaining vigilant, long-term surveillance are critical to preventing diagnostic delays and optimizing clinical outcomes.

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