After a molar pregnancy has been removed, molar tissue may remain and continue to grow. This is called persistent gestational trophoblastic disease (GTD). It occurs in about 1 of every 5 women after a molar pregnancy — usually after a complete mole rather than a partial mole.
One sign of persistent GTD is when the level of human chorionic gonadotropin (HCG) — a pregnancy hormone — remains high after the molar pregnancy has been removed. In some cases, an invasive mole penetrates deep into the middle layer of the uterine wall, which causes vaginal bleeding. Persistent GTD can nearly always be successfully treated, most often with chemotherapy. Another treatment option is removal of the uterus (hysterectomy).
Rarely, a cancerous form of GTD known as choriocarcinoma develops and spreads to other organs. Choriocarcinoma is usually successfully treated with multiple cancer drugs.
Oct. 24, 2014
- Gestational trophoblastic disease. American Cancer Society. http://www.cancer.org/acs/groups/cid/documents/webcontent/003104-pdf.pdf. Accessed July 20, 2014.
- Molar pregnancy. March of Dimes. http://www.marchofdimes.com/loss/molar-pregnancy.aspx. Accessed July 19, 2014.
- Ferri FF. Ferri's Clinical Advisor 2015: 5 Books in 1. Philadelphia, Pa.: Mosby Elsevier; 2015. https://www.clinicalkey.com. Accessed July 19, 2014.
- Goff B. Gestational trophoblastic disease: Management of hydatidiform mole. http://www.uptodate.com/home. Accessed July 19, 2014.
- Baergen RN. Gestational trophoblastic disease: Pathology. http://www.uptodate.com/home. Accessed July 19, 2014.
- Goldstein DP, et al. Gestational trophoblastic disease: Epidemiology, clinical manifestations and diagnosis. http://www.uptodate.com/home. Accessed July 19, 2014.
- Garner EIO. Gestational trophoblastic neoplasia: Staging and treatment. http://www.uptodate.com/home. Accessed July 19, 2014.
- Lentz GM, et al. Comprehensive Gynecology. 6th ed. Philadelphia, Pa.: Mosby Elsevier; 2012. http://www.clinicalkey.com. Accessed July 19, 2014.
- Frequently asked questions. Special procedures FAQ062. Dilation and curettage. American College of Obstetricians and Gynecologists. http://www.acog.org/publications/faq/faq062.cfm. Accessed July 19, 2014.
- American College of Obstetricians and Gynecologists (ACOG) Committee on Practice Bulletins — Obstetrics. ACOG Practice Bulletin No. 53: Diagnosis and treatment of gestational trophoblastic disease. Obstetrics & Gynecology. 2004;103:1365.
- Harms RW (expert opinion). Mayo Clinic, Rochester, Minn. Aug. 6, 2014.