Accepted
at 11:51 a.m. May, 10, 2024
by
mmatheso
Author:
thisisliz
Type of change:
Updated Tags
Rationale for change
updated tags to actual EOR and PANCE (2025) blueprint categories
No changes in fields
Text
Management of Gestational Trophoblastic Disease (molar pregnancy) involves tracking {{c1::β-hCG}} weekly, ordering a(n) {{c1::chest radiograph::imaging}}, performing a(n) {{c1::suction D&C}}, and administering {{c1::OCPs}}.
Extra
Gestational choriocarcinoma (MCC of metastatic GTN) typically metastasizes early to the lung, hence the chest radiograph.
Put her on OCPs to prevent pregnancy; if she gets pregnant it’s impossible to be sure if it’s an invasive mole or a regular pregnancy!
After a miscarriage, normal delivery, or molar pregnancy, if there’s elevation of the B-HCG or its symptoms (listed above), suspect chorio. Diagnose it with an ultrasound first, cut it out with a curettage, and stage it with a CT scan. For localized disease (Stage I) use Methotrexate followed by Actinomycin D (fertility sparing) or TAH (fertility complete). For resistant disease, use MAC (MTX, actinomycin, carboplatin). For advanced stage disease, more aggressive chemo is required: Etoposide, Methotrexate, Actinomycin D, and Carboplatin.
D&C is the right method of removal ONLY if it's in the second trimester.
Lecture Notes
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Pathoma
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Boards and Beyond
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First Aid
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Sketchy
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UWorld
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PancePrepPearls
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Picmonic
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Pixorize
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OME
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