Gestational Trophoblastic Disease

Molar Pregnancy and Gestational Trophoblastic Neoplasia

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Overview

Gestational trophoblastic disease is a rare condition that can create tumors and occur during early pregnancy or following a miscarriage or delivery. Typically the tumors are benign, but they can be cancerous and spread to other organs. Identifying the type of tumor you have early ensures you receive the most effective treatment.

Duke Health gynecologists, gynecologic oncologists, and reproductive endocrinologists are experts in treating the different forms of gestational trophoblastic disease. Our goal is to ensure you receive the best treatment for you and your family planning goals, with minimal side effects. 

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Types of Gestational Trophoblastic Disease

There are two basic types of gestational trophoblastic disease: molar pregnancy and gestational trophoblastic neoplasia, which is a form of cancer. 

Molar Pregnancy
The most common form of the disease occurs during pregnancy. It involves slow-growing, non-cancerous tumors in your uterus, which are typically surgically removed. During a molar pregnancy, fetal tissue may not develop or may not develop completely. 

Gestational Trophoblastic Neoplasia
Sometimes the tumors that form are cancerous and have the potential to spread to other organs. This form of gestational trophoblastic disease can occur after a miscarriage or delivery of a healthy baby.Treatments vary and may include surgery and/or chemotherapy. 

Our Locations

Duke Health offers care at locations in Raleigh and Durham. Read about our clinics in the Triangle.

Tests for Gestational Trophoblastic Disease

Tests Overview

Gestational trophoblastic disease is rare, and the growth of tumors inside your uterus is best treated by a specialist. We use a combination of tests to determine the severity and form of your gestational trophoblastic disease and to identify the exact location of the tumors.

Pelvic Exam

Description

A routine physical exam allows your gynecologist to feel for unusual changes or masses in your vagina, uterus, or cervix.

Blood Tests 

Description

Blood tests can reveal elevated levels of human chorionic gonadotropin, a hormone naturally produced by your body that increases when gestational trophoblastic disease is present. 

Imaging Tests

Description

Ultrasounds and CT scans can identify the location of tumors. Our gynecologic oncologists use the images to determine the best form of treatment. Scans may be repeated after treatment to monitor progress.

Genetic Counseling and Testing

Description

Family history doesn’t always influence gestational trophoblastic disease, but we may refer you to a certified genetic counselor who specialize in hereditary cancer services to determine if cancer found in other family members may impact you. Genetic testing is done by blood test.

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Treatments for Gestational Trophoblastic Disease 

Treatments Overview

In most cases, gestational trophoblastic disease does not affect future pregnancies. Our care teams will collaborate on treatment options to tailor surgery, chemotherapy, or radiation therapy to minimize any impact on your fertility and sexual function. After treatment, you may need to avoid getting pregnant for a short period of time to ensure gestational trophoblastic disease doesn’t return.

Dilation and Curettage (D and C)

Description

Known as a “D and C,” this is the most common treatment for gestational trophoblastic disease. Often it is the only procedure necessary to remove a tumor if you have a molar pregnancy. During this outpatient procedure, your cervix will be dilated, and a long, thin plastic catheter with an open tip will be inserted into your uterus. Your doctor will use the tool to safely remove abnormal tissue.

Chemotherapy

Description

If you’re diagnosed with gestational trophoblastic neoplasia, you may undergo chemotherapy after dilation and curettage to kill any remaining cancerous cells. 

Radiation Therapy

Description

High-energy X-rays target your tumor and kill cancer cells. Our radiation oncologists are specially trained to deliver radiation and minimize damage to surrounding healthy tissue. This treatment is typically an option for cancerous gestational trophoblastic disease that may spread to organs.

Contraception 

Description

To prevent recurrence of gestational trophoblastic disease and to let your body heal, it’s important to not get pregnant while receiving chemotherapy or immediately after treatment. We may recommend contraceptive options until you and your care team determine you’re ready to try to get pregnant again.

Hysterectomy

Description

Hysterectomies are rarely needed to treat gestational trophoblastic disease but may be recommended if your tumor is cancerous or you have completed your childbearing. Hysterectomies are common procedures that remove the uterus through small incisions in the abdomen. This minimally invasive option reduces scarring, minimizes bleeding, shortens your hospital stay, and speeds up your recovery. 

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Why Choose Duke

Support for You and Your Family
Our comprehensive support services range from helping patients minimize the side effects of cancer treatment to coping with the emotional and psychological effects of diagnosis and treatment. View our cancer support groups in our event calendar.

Convenient Appointments
We schedule your appointments quickly, coordinate your schedule with our gynecologic oncologists, and work with you to develop the best treatment plan.

A Nationally Ranked Cancer Program
Women with reproductive system cancers who receive care from gynecologic oncologists have better outcomes. As a National Cancer Institute-designated Comprehensive Cancer Center, we are recognized for using new treatment options based on the latest research discoveries.

Fertility Services for Cancer Survivors
If you are concerned about the impact of chemotherapy and/or radiation on your fertility, experts at the Duke Fertility Center will work closely with you to discuss fertility preservation treatments, which may include egg freezing, tissue banking, and experimental options that are available through our ongoing clinical trials.

This page was medically reviewed on 02/01/2022 by