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Module 5 - GTD
Gestational Trophoblastic Disease
| Question | Answer |
|---|---|
| GTD definition | pathologic proliferation of trophoblastic cells (outermost layer of embryonic cells) |
| Occurs in approx.________ | 1 per 1500 live births |
| Risk factors | Unknown |
| GTD includes_______ | hydatiform mole, invasive mole and choriocarcinoma |
| S/S | vaginal bleeding “prune juice” brownish, may be red, hyperemesis, absence of fetal heart tones and movement |
| uterine enlargement greater than expected for ________is a classic sign of a _______ ________ | GA, COMPLETE mole |
| may have _________ hCG levels | higher than norm |
| Treatment | Suction evacuation – currettage of uterus to remove all fragments of placenta |
| If malignant GTD______ | need for extensive follow up therapy, may need chemotherapy |
| Two types of molar pregnancy are_____ and _____ | complete, partial |
| A complete mole develops from an ovum containing___________ (empty egg), which is fertilized by a _____ ______ | no genetic material, a normal sperm. No embryonic tissues or membranes are found |
| A partial mole usually has a ___________ ________ (69 chromosomes) | triploid karyotype |
| In a partial mole, most often a _____ ______ with 23 chromosomes, is fertilized by ____ ______ (dispermy) or by a sperm that has failed to undergo the first meiotic division and therefore contains 46 chromosomes | normal ovum , two sperms |
| In a partial mole, there may be | a fetal sac or even fetal heartbeat. The fetus has multiple anomalies because of the triplody and little chance for survival |
| Choriocarcinoma seems to be almost associated with the ______ _________ | complete mole |
| Invasive mole is similar to a complete mole, but it invades the_________ | myometrium |
| Serum hCG levels are ____ with molar pregnancy than normal pregnancy | higher |
| If hydropic vesicles are passed, they are_______ | diagnostic |
| Malignant GTD develops following evacuation of the mole in approx._______% of women | 20 |
| To detect malignancy early, all women with GTD should have extensive follow-up ________ | therapy |
| Follow-up care includes a baseline_______ to detect metastasis and physical exam including a ______ exam | chest x-ray, pelvic |
| hCG levels are monitored closely for a year; if there is any plateau or rise in hCG, _________and/or __________ is initiated | methotrexate , chemotherapy |
| Assessment of GTD | Brownish vaginal bleeding at @ 16 weeks * vomiting from elevated hCG * passing of grapelike vesicle * symptoms of PIH before 20 wks (hypertension, proteinuria) |
| Follow up care is ESSENTIAL. It includes baseline ____ ______, _______ levels and ______ exams for a year; Do not get pregnant for at least a year until cleared for choriocarcinoma (pregnancy will elevate hCG) | chest x -ray, hCG, pelvic |
Created by:
CCBCMDNursing218
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