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Williams Obstetrics, 23e
| Section III. Antepartum > |
Chapter 11. Gestational Trophoblastic Disease
Sections: Gestational Trophoblastic Disease: Introduction, Hydatidiform Mole—Molar Pregnancy, Gestational Trophoblastic Neoplasia, References.
Topics Discussed: gestational trophoblastic disease.
Excerpt:"The term gestational trophoblastic disease refers to a spectrum of pregnancy-related placental tumors. Gestational trophoblastic disease is divided into molar and nonmolar tumors. Nonmolar tumors are grouped as gestational trophoblastic neoplasia. The American College of Obstetricians and Gynecologists (2004) terms these as malignant gestational trophoblastic disease. Although these tumors are histologically distinct and have varying propensities to invade and metastasize, it became evident during the 1970s that histological confirmation was not necessary to provide effective treatment. Instead, a system was adopted based principally on clinical findings and serial serum measurements of human chorionic gonadotropin ( -hCG). A number of schemas have been used over the past 30 years to classify these tumors on the basis of malignant potential, and to direct clinical staging and optimal treatment. The International Federation of Gynecology and Obstetrics (FIGO) trophoblastic disease classification scheme is frequently used (Table 11-1). When these management algorithms are followed, most gestational tumors—both benign and malignant—are eminently curable (Berkowitz and Goldstein, 2009)...."
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