What causes Gestational Trophoblastic disease?

What causes Gestational Trophoblastic Disease?

 Gestational Trophoblastic Disease(GTD)

Gestational trophoblastic disease (GTD) is a term used for a group of pregnancy-related tumours. Choriocarcinoma is fast-growing cancer that develops in a woman’s uterus. It is a type of gestational trophoblastic disease. Most Choriocarcinomas develop from persistent hydatidiform moles (usually complete moles). They can also grow when bits of tissues are missing in the uterus post-miscarriage, delivery of a child following a normal pregnancy or an intended abortion.

Types and Symptoms of GTD

Hydatidiform moles

A hydatidiform mole is also known as a molar pregnancy. In a molar pregnancy, there is a difficulty with the fertilized egg, and there is an overproduction of trophoblast tissue. This excess trophoblast tissue develops into abnormal masses that are ordinarily benign but can sometimes turn cancerous. 

There are two types of hydatidiform moles. 

  • Partial molar pregnancy 
  • Complete molar pregnancy

Symptoms

The most common symptoms of hydatidiform mole are vaginal bleeding, which can be either bright red or watery brown discharge. Other symptoms are:

  • Abdominal bloating
  • Vomiting and nausea
  • Fatigue, shortness of breath and lethargic 
  • Signs of an overactive thyroid gland 
  • High blood pressure

Choriocarcinoma is a very malignant form of GTD that overgrows throughout the body and needs vigorous treatment. It may begin as a molar pregnancy or from tissue that remains in the uterus post-miscarriage or childbirth. 

Symptoms

  • Women who develop choriocarcinoma may be asymptomatic, or they usually develop symptoms based on which orangs are involved. 
  • Uterus: Vaginal discharge or bleeding
  • Lung: Chest pain, coughing up blood, or shortness of breath
  • Brain: Headache, trouble with vision, weakness or loss of function,  convulsion
  • Kidney: Blood in urine
  • Bowel: Blood in stool
  • Liver: Abdominal pain

Placental-site trophoblastic tumour

A placental-site trophoblastic tumour is an uncommon form of the disease that arises in the uterus where the placenta is attached. This type of tumours penetrate the muscle layer of the uterus and usually stay confined. Hence, they do not spread to other parts of the body.

When to see a doctor?

If you are experiencing the above symptoms, please visit your doctor. Your doctor will ask how long and how often you have been experiencing the symptoms and run a diagnosis. That may help prevent the further spread of this disease.

GTD Stages

Disease is just in the uterus.

GTD extends outside the uterus but is confined to the genital structures.

GTD spreads to the lungs and may or may not affect the genital tract.

GTD has spread to other distant sites.

Risk Factors

Factors that may raise a woman’s risk of developing GTD:

  •     Age- Pregnant women who are younger than 20 or older than 35 are more exposed to GTD. The risk increases as they grow                older.
  •     Previous molar pregnancy- Molar pregnancy in the past might raise the risk of developing another GTD.
  •     Nutrition/diet- Low levels of carotene and vitamin A in a person’s diet have a higher risk of molar pregnancy according to a                  study.
  •     Family history of molar pregnancy- There have been limited cases of women in the same family having one or more molar                  pregnancies.

Prevention

There are no preventive remedies or treatments for GTD. The only way to prevent this sporadic disease is not to become pregnant.