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Gestational Trophoblastic Disease (Green-top Guideline No. 38)

Published: 04/03/2010

This is the third edition of this guideline. It replaces The Management of Gestational Trophoblastic Neoplasia, published in 2004, which in turn replaced The Management of Gestational Trophoblastic Disease, issued in April 1999 as Guideline No. 18.

The fourth edition of this guideline is currently in development.

Update December 2014: New evidence and guidance in this field were reviewed in 2014 and it was decided that revision of this guideline would be deferred to a later date. The version available on the website and app will remain valid until replaced.

Gestational trophoblastic disease (GTD) forms a group of disorders spanning the conditions of complete and partial molar pregnancies through to the malignant conditions of invasive mole, choriocarcinoma and the very rare placental site trophoblastic tumour (PSTT). There are reports of neoplastic transformation of atypical placental site nodules to placental site trophoblastic tumour.

If there is any evidence of persistence of GTD, most commonly defined as a persistent elevation of beta human chorionic gonadotrophin (βhCG), the condition is referred to as gestational trophoblastic neoplasia (GTN).

The purpose of this guideline is to describe the presentation, management, treatment and follow-up of GTD and GTN. It also provides advice on future pregnancy outcomes and the use of contraception.