Резюме
Определение
Анамнез и осмотр
Ключевые диагностические факторы
- first trimester of pregnancy
- vaginal bleeding
- unusual uterine size for gestational age
Другие диагностические факторы
- early-onset preeclampsia
- shortness of breath and respiratory distress
- severe nausea and emesis
- tachycardia, tremor, insomnia, and diarrhea
- pallor
- pelvic pain
- uterine bleeding
Факторы риска
- extremes of maternal age
- prior molar pregnancy
- diminished dietary fat and carotene
Диагностические исследования
Исследования, которые показаны в первую очередь
- histologic exam of placental tissue
- serum human chorionic gonadotropin (hCG)
- pelvic ultrasound
Исследования, проведение которых нужно рассмотреть
- CBC
- serum PT, PTT
- serum metabolic panel
- serum thyroid-stimulating hormone (TSH)
- blood type with antibody screen
- CXR
Алгоритм лечения
singleton molar pregnancy: desiring fertility
singleton molar pregnancy: not desiring fertility
viable twin fetus: elective termination not desired
viable twin fetus: elective termination
following initial management: high risk of gestational trophoblastic neoplasia with completed follow up unlikely
Составители
Авторы
Antonio Braga, MD
Associate Professor
Department of Obstetrics and Gynecology
Rio de Janeiro Federal University
Department of Maternal Child
Fluminense Federal University
Rio de Janeiro
Brazil
Раскрытие информации
AB is an author of references cited in this topic.
Kevin M. Elias, MD
Assistant Professor
Brigham and Women’s Hospital
Dana Farber Cancer Institute
New England Trophoblastic Disease Center
Division of Gynecologic Oncology
Department of Obstetrics, Gynecology and Reproductive Biology
Harvard Medical School
Boston
MA
Раскрытие информации
KME has been a paid consultant for AOA Dx and received research support from Aspira Women’s Health and Abcam, Inc. KME is an author of references cited in this topic.
Neil S. Horowitz, MD
Associate Professor
Brigham and Women’s Hospital
Dana Farber Cancer Institute
New England Trophoblastic Disease Center
Division of Gynecologic Oncology
Department of Obstetrics, Gynecology and Reproductive Biology
Harvard Medical School
Boston
MA
Раскрытие информации
NSH is an author of references cited in this topic.
Ross S. Berkowitz, MD
William H. Baker Professor of Gynecology
Brigham and Women’s Hospital
Dana Farber Cancer Institute
New England Trophoblastic Disease Center
Division of Gynecologic Oncology
Department of Obstetrics, Gynecology and Reproductive Biology
Harvard Medical School
Boston
MA
Раскрытие информации
RSB is an author of references cited in this topic.
Выражение благодарностей
Dr Ross S. Berkowitz, Dr Kevin M. Elias, Dr Neil S. Horowitz, and Dr Antonio Braga would like to gratefully acknowledge Dr John Soper and Dr Emma Rossi, previous contributors to this topic. JS and ER declare that they have no competing interests.
Рецензенты
Jane Stewart, PhD, MSc
Consultant Gynecologist
Subspecialist in Reproductive Medicine
Newcastle Fertility Centre at Life
Bioscience Centre
International Centre at Life
Newcastle upon Tyne
UK
Раскрытие информации
JS declares that she has no competing interests.
Philip Savage, PhD, FRCP
Consultant in Medical Oncology
Department of Medical Oncology
Charing Cross Hospital
London
UK
Раскрытие информации
PS declares that he has no competing interests.
Aparna Sundaram, DO, MBA, MPH
Physician Consultant
Preventive Medicine
Private Practice
Atlanta
GA
Раскрытие информации
AS declares that she has no competing interests.
Peer reviewer acknowledgements
BMJ Best Practice topics are updated on a rolling basis in line with developments in evidence and guidance. The peer reviewers listed here have reviewed the content at least once during the history of the topic.
Disclosures
Peer reviewer affiliations and disclosures pertain to the time of the review.
Список литературы
Основные статьи
Horowitz NS, Eskander RN, Adelman MR, et al. Epidemiology, diagnosis, and treatment of gestational trophoblastic disease: A Society of Gynecologic Oncology evidenced-based review and recommendation. Gynecol Oncol. 2021 Dec;163(3):605-13.Полный текст Аннотация
Ngan HYS, Seckl MJ, Berkowitz RS, et al. Diagnosis and management of gestational trophoblastic disease: 2021 update. Int J Gynaecol Obstet. 2021 Oct;155 Suppl 1(suppl 1):86-93.Полный текст Аннотация
Tidy, J, Seckl, M, Hancock, BW, on behalf of the Royal College of Obstetricians and Gynaecologists. Management of gestational trophoblastic disease. BJOG 2021;128: e1-e27.Полный текст
Lok C, van Trommel N, Massuger L, et al. Practical clinical guidelines of the EOTTD for treatment and referral of gestational trophoblastic disease. Eur J Cancer. 2020 May;130:228-40. Аннотация
Статьи, указанные как источники
A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.
Отличия
- Hyperemesis gravidarum
- Spontaneous abortion
- Multiple gestation
Больше ОтличияРекомендации
- Epidemiology, diagnosis, and treatment of gestational trophoblastic disease
- Diagnosis and treatment of gestational trophoblastic disease
Больше Рекомендации
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