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

Published: 30/09/2020

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This update was undertaken as part of the regular updates to Green-top Guidelines as outlined in our document Developing a Green-top Guideline: Guidance for developers (PDF 2.4mb) and prior to the emergence of the new COVID-19 coronavirus. Please note that the information provided in this update will be considered for update 3 years after publication, with an intermediate assessment of the need to update 2 years after publication.

This is the fourth edition of this guideline. The third edition was published under the same title in 2010. The second edition was published in 2004, titled The Management of Gestational Trophoblastic Neoplasia, which replaced The Management of Gestational Trophoblastic Disease, published in April 1999.

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.


Declarations of interest

Professor J Tidy: None declared.
Professor M Seckl: None declared.
Professor BW Hancock: None declared.


Full disclosures of interest for the developers, Guidelines Committee and peer reviewers are available to view online on Wiley as supporting information.