What should you know about gestational trophoblastic disease (GTD)?

GTD begins in trophoblastic cells, which support attachment and development of a pregnancy. A molar pregnancy is a non-viable pregnancy in which this tissue grows abnormally. Some forms remain in the uterus; others can persist after a molar pregnancy and are called gestational trophoblastic neoplasia. Choriocarcinoma is one type. A pregnancy hormone called human chorionic gonadotrophin, or hCG, helps clinicians follow the condition because its level should fall after treatment of a molar pregnancy.

Arrange follow-up with your gynaecology or oncology team. Monitoring commonly includes hCG blood tests, and sometimes urine tests, scans or an examination. Keep every appointment so a persistent rise or plateau can be assessed promptly. Use contraception if your team advises it while hCG is being followed, because a new pregnancy can make the results difficult to interpret. Treatment depends on the type and extent of disease; chemotherapy may be recommended when abnormal tissue remains or has spread.

Seek urgent medical help for heavy vaginal bleeding, fainting, severe pelvic or abdominal pain, breathlessness, chest pain, a severe headache, confusion or a seizure. Contact your treating team promptly for renewed bleeding or bleeding between periods, increasing pain, fever, or an hCG result that does not follow the expected pattern. These symptoms need assessment; they do not by themselves establish the cause.

Which type of GTD has been diagnosed, and what did the pathology or scan show? How often will hCG be checked, and when will monitoring finish? Should I use contraception during follow-up? What symptoms should prompt same-day advice? If treatment is needed, why is chemotherapy or another approach being recommended?