Overview
Introduction
An unexpectedly high hCG, uterine size ahead of the gestational dates, severe vomiting, vaginal bleeding, or preeclampsia like findings before 20 weeks should make the nurse que...
An unexpectedly high hCG, uterine size ahead of the gestational dates, severe vomiting, vaginal bleeding, or preeclampsia-like findings before 20 weeks should make the nurse question whether abnormal trophoblastic tissue is driving the pregnancy presentation. Gestational trophoblastic disease (GTD) ranges from premalignant complete and partial hydatidiform moles to gestational trophoblastic neoplasia (GTN), including invasive mole, choriocarcinoma, placental site trophoblastic tumour (PSTT), and epithelioid trophoblastic tumour (ETT). The same hormone that helps identify the disease — quantitative hCG — can also produce hyperemesis, ovarian theca lutein cysts, and clinically dangerous thyrotoxicosis. After evacuation, hCG becomes the surveillance signal: a predictable fall supports resolution, whereas a plateau, rise, persistent elevation, or metastatic finding requires prompt specialist assessment.