Table of Contents
What does trophoblastic proliferation mean?
Gestational trophoblastic disease (GTD) is a term used for a group of pregnancy-related tumours. These tumours are rare, and they appear when cells in the womb start to proliferate uncontrollably.
What is a trophoblastic tumor?
A placental-site trophoblastic tumor (PSTT) is a rare type of gestational trophoblastic neoplasia that forms where the placenta attaches to the uterus. The tumor forms from trophoblast cells and spreads into the muscle of the uterus and into blood vessels. It may also spread to the lungs, pelvis, or lymph nodes.
What is a trophoblastic?
(TROH-foh-BLAST) A thin layer of cells that helps a developing embryo attach to the wall of the uterus, protects the embryo, and forms a part of the placenta.
How is GTD diagnosed?
In addition to a physical examination, the following tests may be used to diagnose GTD:
- Pelvic examination.
- Human chorionic gonadotropin (hCG) test.
- Other lab tests.
- Ultrasound.
- X-ray.
- Computed tomography (CT or CAT) scan.
- Magnetic resonance imaging (MRI).
What causes GTD?
Causes of Gestational Trophoblastic Disease Age: Gestational trophoblastic disease occurs in women of childbearing age. History of molar pregnancy. Prior miscarriage(s) or problems getting pregnant.
Can you get pregnant with gestational trophoblastic disease?
Getting pregnant again after GTD It is safe to get pregnant after a GTD depending on the type of treatment you have had. If your only treatment was a D and C, you can usually try to get pregnant as soon as your hCG follow up is complete. If you became pregnant earlier you would have hCG in your blood and urine tests.
Is gestational trophoblastic disease painful?
More rarely, women with advanced GTD may have severe abdominal pain, shortness of breath, or headache/dizziness. There are risk factors that are known to be associated with an increased likelihood of developing GTD.
What is trophoblastic reaction in pregnancy?
A well defined trophoblastic reaction, continuous around the gestational sac, is a very good prognostic sign for continued viability; a sac greater than 2 cm in diameter without embryonic echoes is a poor prognostic sign.
What is trophoblast invasion?
Trophoblast invasion lays the foundations for pla- centation, as the extent of invasion determines the quality of anchorage and depth of the placenta, ensuring that it will not detach. Trophoblast invasion of the maternal spiral arteries is important in ensuring adequate fetal oxygen and nutrient supply.
What is the cause of trophoblastic disease?
The most common types of gestational trophoblastic disease occur when a sperm cell fertilizes an empty egg cell or when two sperm cells fertilize a normal egg cell. Your risk is higher based on your: Age: Gestational trophoblastic disease occurs in women of childbearing age.
What is the most common form of GTD?
Hydatidiform mole (HM) or molar pregnancy is the most common form of GTD. It is most often benign (non-cancerous) and stays in the uterus.
How is trophoblastic disease diagnosed?
Screening for Gestational Trophoblastic Disease CA-125 blood test: A blood test to determine if a tumor is present in your body. Serum tumor marker test: A blood test to measure the amount of beta human chorionic gonadotropin (β-hCG) in the body. This is a hormone that the body makes during pregnancy.
Is gestational trophoblastic disease fatal?
In total, 1044 patients were admitted during the study period, 164 cases (15.7%) of gestational trophoblastic neoplasia (GTN) were diagnosed and 21 deaths occurred leading to a specific lethality of 12.8% (21/164).
What is trophoblastic disease in pregnancy?
Gestational trophoblastic disease is the name given to a group of tumors that form during abnormal pregnancies. GTD is rare, affecting about one in every 1,000 pregnant women in the U.S. While some GTD tumors are malignant (cancerous) or have the potential to turn cancerous, the majority are benign (noncancerous).
Is trophoblastic disease genetic?
Genetics of gestational trophoblastic tumours GTTs are characterised by trophoblastic differentiation of the tumour tissue and production of human chorionic gonadotropin (hCG). The tumours can arise from a CHM, a PHM or any non-molar pregnancy, with their genetic makeup reflecting the pregnancy of origin.
When does trophoblast invasion occur?
1 Endovascular trophoblast invasion has been reported to occur in two waves; the first into the decidual segments of spiral arteries at 8 to 10 weeks of gestation and the second into myometrial segments at 16 to 18 weeks of gestation.
What is trophoblast invasion in pregnancy?
What is circumferential proliferation of cytotrophoblast and intermediate trophoblast?
Circumferential proliferation of cytotrophoblast, intermediate trophoblast, and syncytiotrophoblast is prominent ( Figures 34.14 and 34.15 ), sometimes forming large sheets of trophoblast around the edematous villi.
What is the pathophysiology of villous trophoblastic proliferation?
Villous trophoblastic proliferation is minimal or is frequently proliferated in a polar fashion ( Figure 34.9 ), resembling polar proliferation of normal anchoring villi in early developing placentas. Trophoblastic pseudoinclusions, although often present, are not diagnostic, as they also may be seen in partial moles and aneuploid gestations.
What are trophoblasts and blastocysts?
Blastocyst with an inner cell mass and trophoblast. Trophoblasts (from Greek ‘trephein’: to feed; and ‘blastos’: germinator) are cells that form the outer layer of a blastocyst. They are present four days post- fertilization in humans.
What is interstitial trophoblast cytology?
Interstitial (intermediate) trophoblast cytology is similar to that of surrounding decidualized stromal cells (Figure 34. 5A–D), but the trophoblast nuclei are slightly larger, irregular, and hyperchromatic.