Gestational Trophoblastic Disease

Gestational Trophoblastic Disease

by: Leeyannah Santos

Overview

What is it?

• Group of pregnancy-related tumors
• Begins when cells in the womb multiply uncontrollably
• Tumors are called trophoblasts and comes from tissues that form the placenta
• Sometimes the trophoblast layer can turn into placenta - benign
• Molar pregnancy (hydatidiform mole) - Tissue that usually forms a fetus instead becomes an abnormal growth in the uterus
• Usually affects women who are pregnant; sometimes postmenopausal women

Causes

• Trophoblast, cells in the womb and tissue of placenta, grow rapidly and do not stop
• It starts during a pregnancy
• Most tumors come from complete persistent hydatidiform moles
• sperm fertilizes abnormal egg with no nucleus
• after fertilization, there is division
• No fetus is formed
• Some --- Partial hydatidiform moles
• Two sperm to one egg; emrbyo has three sets of chromosomes -> cannot grow into a normally developed infant

Sources

Prevention

• Don't get pregnant
• If you are pregnant, there is always a small chance that you can get it.

• http://www.ncbi.nlm.nih.gov/pubmed/11869089
• http://en.wikipedia.org/wiki/Gestational_trophoblastic_disease#Cause
• http://www.webmd.com/baby/tc/molar-pregnancy-topic-overview
• http://www.patient.co.uk/doctor/gestational-trophoblastic-disease
• http://www.michigan.gov/mdch/0,1607,7-132-2940_4909_6437_19077-46301--,00.html
• http://www.cancer.org/cancer/gestationaltrophoblasticdisease/detailedguide/gestational-trophoblastic-disease-staging
• http://www.cancer.org/cancer/gestationaltrophoblasticdisease/detailedguide/gestational-trophoblastic-disease-key-statistics
• http://www.ncbi.nlm.nih.gov/pubmed/20795347

Statistics, Pictures, Prognosis

Pictures

Statistics

• U.S. - 1/1000 pregnancies
• Account for < 1% of female reproductive system cancers
• Cure rate:
• 100% of women can be cured
• 80-90% of high-risk are cured
• will likely require intensive treatment

Examination and Treatments

Treatment

Examinations

Prognosis and CAM

• Termination of pregnancy
• Suction curettage
• (1) dilation of cervix (2) tube attached to a pump is inserted and suctions out the fetus, placenta, and other contents (3) scrape walls of uterus with curette to assure there are no remnants
• Chemotherapy
• Methrotrexate and dactinomycin
• Radiotherapy - areas affected by the cancer

• Urine and blood levels of hCG
• hCG - Human Chorionic Gonadotropin
• Will detect molar pregnancies --- GTD
• Histological Examination
• study of microscopic anatomy of cells and tissues
• It will determine which tissue the tumor grew from
• Ultrasound
• Second trimester
• Not very reliable

• Hydatidiform mole - excellent prognosis
• Malignant GTD - very good
• Usually all women are cured and stay fertile
• Only some will have poor prognosis - Stage IV

• Mental prayer/healing
• Fruit juices/vegetables diet
• Banaba/taheebo tea
• Multivitamins

Stages of Cancer

Stage 1: The tumor stays confined in the uterus

Stage 2: Tumor has spread to other genital structures but still stays within the pelvic region

Stage 3: Tumor spreads to lungs

Stage 4: Tumor spreads to other organs like the brain, kidneys, and liver

Inside Look

Closer Look at the Cellular Level

Diagnosis and Symptoms

• Routine tests throughout pregnancy
• Blood tests and ultrasounds
• Found early in prenatal care
• Test after miscarriage and abortion
• Pregnancies with complications

• Vaginal bleeding, enlarged uterus, pelvic pain/comfort, hyperemesis --- too much vomiting

• Two most common instances:
• One egg and two sperm
• three sets of chromosomes --- cannot develop fetus
• One abnormal egg ( no nucleus) and a sperm
• only DNA from paternal side --- cannot develop fetus

Genetics and Risk Factors

• Increase chances:
• age < 20 and > 35
• Asian ethnicity
• Previous case of GTD
• Use of contraceptive pill
• It is not hereditary, can be triggered by a pregnancy or an abortion