Abstract
Up to 15–20% of complete hydatidiform mole and 1–5% partial hydatidiform mole may develop Gestational Trophoblastic Neoplasia (GTN) including choriocarcinoma, which is potentially fatal. Serial assay and monitoring of human chorionic gonadotrophin (hCG) levels is essential for early diagnosis of GTN following hydatidiform mole. However, many regions in India lack specialist GTD referral centers, thereby limiting the provision of timely and optimum care, resulting in morbidity and mortality from this eminently curable cancer. With the establishment of Regional GTD centers, implementing a validated protocol-based management, GTN following hydatidiform mole can be diagnosed early and managed with limited use of chemotherapeutic agents achieving high levels of long-term survival as well as preservation of fertility.
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Appendix
Appendix
Data collection for GTD register
Name ——————— Age ———————
Address ———————
Mail ID ——————— Phone no. ———————
Parity ——————— LMP ———————Period of gestation in weeks ———————
Clinical presentation
Hyperemesis ——————— Bleeding P/V ——————— Passing of vesicles ———————
USG findings ——————— Complete mole/partial mole ———————
Blood gp. CBC, TSH, Pre-evacuation hCG
Method of evacuation ———————
Histopathology
USG after 1 week- residual products- repeat curettage.
- Weekly serum hCG:
-
hCG after 4 weeks (> 20,000 IU/L—Chemotherapy)
Post evacuation bleeding
- Persistence of lutein cysts:
-
Sub-urethral nodule
- Plateauing/rise in hCG:
-
GTN
- Metastatic workup:
-
X-ray chest, USG abdomen, CT abdomen, MRI brain
Chemotherapy regimen
No. of courses—Response
Follow-up
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Paradan K, S. (2021). Establishment of Regional Centers for Gestational Trophoblastic Disease Follow-Up and Referral and Gestational Trophoblastic Disease Registry. In: Nayak, B., Singh, U. (eds) Gestational Trophoblastic Disease. Springer, Singapore. https://doi.org/10.1007/978-981-33-4878-3_18
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DOI: https://doi.org/10.1007/978-981-33-4878-3_18
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