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Health  2023 

Updates in the Diagnosis of Gestational Trophoblast Disease

DOI: 10.4236/health.2023.151004, PP. 48-58

Keywords: Diagnosis, Gestational Trophoblastic Disease, Updates

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Abstract:

GTD (Gestational Trophoblastic Disease) is a pathology that encompasses benign and malignant clinical forms, affects women of childbearing age, has a variable incidence and is more frequent in developing or underdeveloped countries, colliding with the economic barrier. The frequent absence of clear protocols and guidelines for the correct diagnosis of the pathology results in inadequate classification, imprecise treatment and failed post-therapeutic observation, increasing the risk of relapses, morbidity and mortality. The present study aims to point out updated national and international practice protocols of diagnosis of GTD, through an integrative review. Seven articles were selected and it was observed that the main international reference centers are agreed with the management suggested by the IFGO (International Federation of Gynecology and Obstetrics), being the conduct in the Hydatidiform Mole (HM): evacuation by suction and curettage under ultrasound guidance, followed by hCG monitoring every 1 - 2 weeks until normalized (usually one month for Partial Hydatidiform Mole six months for Complete Hydatidiform Mole and one year for Gestational Trophoblastic Neoplasia). Unfortunately, regarding the diagnosis of MH, the guidelines of some countries show the absence or difficulty of access to the karyotype test and ploid p57 or pelvic ultrasound accompanying the uterine curettage, contrary to what is proposed by the IFGO guideline. Establishing and complying with consistent guidelines can improve patient care, with early diagnosis of the pathology and its complications, reducing the rate of recurrence, morbidity and mortality, especially in less developed countries.

References

[1]  Ferraz, L., et al. (2015) Atualizacao no diagnóstico e tratamento da gravidez molar. Revista Jornal Brasileiro de Medicina, 103, 6-12.
[2]  Braga, A., et al. (2019) Challenges in the Diagnosis and Treatment of Gestational Trophoblastic Neoplasia Worldwide. World Journal of Clinical Oncology, 10, 28-37.
https://doi.org/10.5306/wjco.v10.i2.28
[3]  Santaballa, A., et al. (2018) SEOM Clinical Guidelines in Gestational Trophoblastic Disease (2017). Clinical & Translational Oncology, 20, 38-46.
https://doi.org/10.1007/s12094-017-1793-0
[4]  Lima, L.L.A., et al. (2016) Correlacoes clínico radiológicas em pacientes com doenca trofoblástica gestacional. Radiologia Brasileira, 49, 241-250.
[5]  Mota, M.L.O., et al. (2022) Mola Hidatiforme: Apresentacoes Clínicas Benignas da Doenca Trofoblástica Gestacional. In: de Freitas, G.L., Sleiman, H.K. and de A. Paganini, J.C., Eds., Saúde da Mulher: Epidemiologia, intervencoes, casos clínicos e políticas de saúde, 6th Edition, Pasteur, Irati, 137-143.
https://doi.org/10.29327/568096.6-16
[6]  Braga, A., et al. (2019) Doenca trofoblastica gestacional. Protocolo Febrasgo—Obstetrícia, n. 23, Comissao Nacional Especializada em Doenca Trofoblastica Gestacional. Femina, 47, 6-17.
[7]  Clark, J.J., et al. (2021) Treatment of Gestational Trophoblastic Disease in the 2020s. Current Opinion in Obstetrics and Gynecology, 33, 7-12.
https://doi.org/10.1097/GCO.0000000000000674
[8]  Ngan, H.Y.S., et al. (2018) Update on the Diagnosis and Management of Gestational Trophoblastic Disease. International Journal of Gynecology & Obstetrics, 143, 79-85.
https://doi.org/10.1002/ijgo.12615
[9]  Brasil. Ministério da Saúde (2022) Linha de cuidados para doenca trofoblástica gestacional [recurso eletronico]. Associacao Brasileira de Doenca Trofoblástica Gestacional. Ministério da Saúde, Brasília.
[10]  Tsakiridis, I., et al. (2020) Diagnosis and Management of Gestational Trophoblastic Disease: A Comparative Review of National and International Guidelines. Obstetrical & Gynecological Survey, 75, 747-756.
https://doi.org/10.1097/OGX.0000000000000848
[11]  Xing, D., et al. (2021) Refined Diagnosis of Hydatidiform Moles with p57 Immunohistchemistry and Molecular Genotyping: Updated Analysis of a Prospective Series of 2217 Cases. Modern Pathology, 34, 961-982.
https://doi.org/10.1038/s41379-020-00691-9
[12]  Khachani, I., et al. (2017) Implementation and Monitoring of a Gestational Trophoblastic Disease Management Program in a Tertiary Hospital in Morocco: Opportunities and Challenges. Obstetrics and Gynecology International, 2017, Article ID: 5093472.
https://doi.org/10.1155/2017/5093472
[13]  Heller, D.S. (2017) Update on the Pathology of Gestational Trophoblastic Disease. APMIS, 126, 647-654.
https://doi.org/10.1111/apm.12786
[14]  Alexander, A.L., et al. (2020) Placental Site Trophoblastic Tumor: Successful Treatment of 13 Cases. Gynecologic Oncology Reports, 13, 1-4.
https://doi.org/10.1016/j.gore.2020.100548
[15]  Maestá, I., et al. (2000) Características das Curvas de Regressao da Gonadotrofina Corionica Pós-mola Hidatiforme Completa. Revista Brasileira de Ginecologia e Obstetrícia, 22, 373-380.
https://doi.org/10.1590/S0100-72032000000600008

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