GTD - Introduction

Question 1

Complete moles

Answer 1

• Diploid and androgenic
• 75–80% arise as a consequence of duplication of a single sperm in an empty ovum
• 20–25% can arise after dispermic fertilisation

Question 2

Partial moles

Answer 2

• 90% triploid in origin
• Two sets of paternal haploid genes and
  one set of maternal haploid genes
• 10% of partial moles represent tetraploid or mosaic conceptions.

Question 3

Incidence of molar pregnancy

Answer 3

1/714 live births

Question 4

Incidence of GTN

Answer 4

1 : 50 000 live births

Question 5

Atypical symptoms of molar pregnancy

Answer 5

• Hyperthyroidism
• Early onset pre-eclampsia
• Abdominal distension due to theca lutein cysts
• Very rarely, women can present with acute respiratory failure or neurological symptoms such as seizures; these are likely to be due to metastatic disease

Question 6

Second ERPC

Answer 6

Consider if hCG

Question 7

Normal pregnancy with coexisting molar

Answer 7

• 25% chance of achieving a live birth
• Early fetal loss 40%
• Premature delivery 36%
• Risk of PET 20%