Signs
and Symptoms of Gestational Trophoblastic Disease A high percentage of
women with bleeding in the first trimester, with threatened abortions or with
ectopic pregnancies are at risk of developing a molar pregnancy. The physician will find this setting highly suspicious
and check the blood for increased titers of the beta-subunit of human chorionic
gonadotropin (HCG level or beta-HCG). This blood test is a very specific marker
for gestational trophoblastic disease. There can be passing of grape-like
structures, called "villi", which are parts of the trophoblastic disease
that is shed by the uterus. Patients with molar pregnancies tend to have a uterus
size, which is much larger than expected for a normal pregnancy and there are
many more complications. There is more vomiting and severe nausea, there
may be intrauterine infection and blood poisoning. Also, a condition called toxemia,
which is charaterized by high blood pressure and protein leakage into the urine
and is normally found only towards the end stage, is often present right from
the beginning of the pregnancy. As long as the trophoblastic disease is in place,
there is the danger of developing kidney disease when toxemia is present. When distant metastases are present from a choriocarcinoma, which
is the case in about 5% of patients with molar pregnancies, they are found in
the majority of cases in the lungs and the local tissues like the vagina and the
pelvis. Other sites for distant metastases are the liver, spleen,the bowel, the
kidneys and the brain. Liver metastases and brain metastases are most feared as
there are only very few survivors in these conditions even after combination chemotherapy
and there are no other treatment alternatives yet.
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