Gestational trophoblastic disease I: epidemiology, pathology, clinical presentation and diagnosis of gestational trophoblastic disease, and management of hydatidiform mole

Lurain, John R.

doi:10.1016/j.ajog.2010.06.073

Cited by 646 publications

(694 citation statements)

References 45 publications

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“…Although choriocarcinoma has been reported to affect approximately 1 in 40 000 to 9 in 40 000 pregnancies [3], the incidence rates have been declining. PSTT and ETT are rarer than choriocarcinoma.…”

Section: Epidemiologymentioning

confidence: 99%

“…Therefore, clinical presentations vary from abnormal vaginal bleeding; bleeding from metastatic sites in the abdomen, lung, or brain; pulmonary symptoms; and neurological signs from spine or brain metastasis [3]. GTN should be considered in the differential diagnosis of patients with unusual presentations and serum hCG should be performed as part of the workup of such patients.…”

Section: Gestational Trophoblastic Neoplasia After Non-molar Pregnancymentioning

confidence: 99%

“…Recent data show that GTN rarely occurs after the hCG has spontaneously returned to normal and hence contraception for only 6 months rather than 1 year is now recommended [3,17]. Termination of pregnancy is not indicated if accidental pregnancy occurs during surveillance after the hCG level has returned to normal.…”

Section: Molar Pregnancymentioning

confidence: 99%

“…Histologically, it includes the benign partial and complete hydatidiform mole, invasive and metastatic mole, as well as the malignant choriocarcinoma, placental site trophoblastic tumor (PSTT), and epithelioid trophoblastic tumor (ETT). Molar pregnancies may develop persistent elevated serum human chorionic gonadotropin (hCG) levels after evacuation (complete mole 15%−20%, partial mole 0.1%−5% [1][2][3]), with a chance of progression to choriocarcinoma that may require treatment. Together with the malignant forms of GTD these are grouped under gestational trophoblastic neoplasia (GTN).…”

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Update on the diagnosis and management of gestational trophoblastic disease

Ngan

Seckl

Berkowitz

et al. 2015

Intl J Gynecology & Obste

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403

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Section: Epidemiologymentioning

confidence: 99%

Section: Gestational Trophoblastic Neoplasia After Non-molar Pregnancymentioning

confidence: 99%

Section: Molar Pregnancymentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Update on the diagnosis and management of gestational trophoblastic disease

Ngan

Seckl

Berkowitz

et al. 2015

Intl J Gynecology & Obste

Self Cite

251

403

View full text Add to dashboard Cite

“…Choriocarcinoma is a rare, aggressive subtype of gestational trophoblastic neoplasia that affects an estimated 1 in 24,000 1 to 1 in 40,000 2 , 3 pregnancies in the United States. The disease has a propensity for metastasis to the lungs, brain, liver, vagina, and pelvis and arises from hydatidiform moles in about 50% of cases, although choriocarcinoma can be associated with any type of pregnancy 2 .…”

Section: Introductionmentioning

confidence: 99%

The use of middle cerebral artery Doppler ultrasonography to guide delivery of a viable pregnancy complicated by metastatic gestational chroriocarinoma

Thagard

Dubil

Lee

et al. 2013

Australas J Ultrason Med

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Background: Choriocarcinoma is a rare, aggressive subtype of gestational trophoblastic neoplasia. The diagnosis of metastatic choriocarcinoma in the setting of a viable intrauterine pregnancy is exceedingly rare and often associated with feto‐maternal hemorrhage. Case: An otherwise healthy Gravida 1 Para 0 at 34 weeks gestational age presented with metastatic choriocarcinoma and a viable fetus. Measured Doppler peak systolic velocity of the middle cerebral artery was used to detect fetal anemia, thus optimising the timing of delivery. Conclusion: This is the first case report to our knowledge using Doppler ultrasonography to detect fetal anemia in an effort to guide delivery in a case of choriocarcinoma diagnosed during pregnancy. If choriocarcinoma is diagnosed during pregnancy, middle cerebral artery Doppler ultrasonography may serve as a critical tool to help detect anemia, allowing pregnancy prolongation to promote fetal maturity while screening for the development of feto‐maternal hemorrhage.

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First-line chemotherapy in low-risk gestational trophoblastic neoplasia

Alazzam

Tidy

Hancock

et al. 2012

Cochrane Database of Systematic Reviews

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Dactinomycin is more likely to achieve a primary cure in women with low-risk GTN, and less likely to result in treatment failure, compared with methotrexate. There is limited evidence relating to side-effects, however, the pulsed dactinomycin regimen does not appear to be associated with significantly more side-effects than the low-dose methotrexate regimen and therefore should compare favourably to the five- and eight-day methotrexate regimens in this regard.We consider pulsed dactinomycin to have a better cure rate than, and a side-effect profile at least equivalent to, methotrexate when used for first-line treatment of low-risk GTN. Data from a large ongoing trial of pulsed dactinomycin compared with five- and eight-day methotrexate regimens is likely to have an important impact on our confidence in these findings.

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Gestational trophoblastic disease I: epidemiology, pathology, clinical presentation and diagnosis of gestational trophoblastic disease, and management of hydatidiform mole

Cited by 646 publications

References 45 publications

Update on the diagnosis and management of gestational trophoblastic disease

Update on the diagnosis and management of gestational trophoblastic disease

The use of middle cerebral artery Doppler ultrasonography to guide delivery of a viable pregnancy complicated by metastatic gestational chroriocarinoma

First-line chemotherapy in low-risk gestational trophoblastic neoplasia

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