Advances in the diagnosis and early management of gestational trophoblastic disease

Early identification of women with Gestational Trophoblastic Disease is paramount as this disorder is highly curable.


Caroline Joyce, Brendan Fitzgerald, Keelin O'Donoghue

Journal Name
BMJ Medicine
Journal Article
Molar pregnancy / Gestational Trophoblastic Disease

Biomarkers for Gestational Trophoblastic Disease

Full Citation

Joyce CM, Fitzgerald B, McCarthy TV, Coulter J, O'Donoghue K. Advances in the diagnosis and early management of gestational trophoblastic disease. BMJ Medicine. 2022;1:e000321.

Link to Publication


This review highlights recent developments in the field of Gestational Trophoblastic Disease (GTD). These include earlier diagnosis of molar pregnancy, changes to the surveillance period following molar pregnancy and new therapies for women with highly resistant disease. The article provides information on the incidence rates, risk factors and the origin of molar pregnancies. Pathological examination of placental tissue confirms the diagnosis of GTD but this can be challenging as highlighted in article. The pregnancy hormone human chorionic gonadotrophin (HCG) is used to monitor women following molar pregnancy and the need for a centralised HCG testing service for management of this rare disease is discussed. A small number of women with molar pregnancy go on to develop malignant disease. The need to identify these women at an early stage and provide appropriate chemotherapy is an active area research. Some women develop malignant disease years after molar pregnancy and molecular genetics can help identify the linked pregnancy which has implications for both treatment and prognosis. Of note, there are many new treatment options for women who are resistant to chemotherapy including use of immunotherapy. The psychological impact of GTD diagnosis on women and their families is also considered in this review.

Pregnancy Loss Research Group

Pregnancy Loss Research Group, Department of Obstetrics & Gynaecology, University College Cork, Fifth Floor, Cork University Maternity Hospital, Wilton, Cork, T12 YE02, Ireland,