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


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.

COVID disclaimer

This guideline developed as part of the regular programme of Green-top Guidelines, as outlined in our document Developing a Green-top Guideline: Guidance for developers (PDF), and prior to the emergence of COVID-19.

Version history

This is the fourth edition of this guideline.

Please note that the information provided in this update will be considered for update by the RCOG Guidelines Committee 3 years after publication, with an intermediate assessment of the need to update 2 years after publication.

Developer declaration of interests

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

This page was last reviewed 30 September 2020.