scholarly journals Significance of transvaginal Doppler ultrasonography for detection of malignant gestational trophoblastic disease

2005 ◽  
Vol 62 (2) ◽  
pp. 103-105 ◽  
Author(s):  
Branka Nikolic ◽  
Snezana Rakic ◽  
Dejan Pavlovic ◽  
Svetlana Popovac ◽  
Relja Lukic
Keyword(s):  
Early Detection ◽  
Blood Vessels ◽  
Doppler Ultrasonography ◽  
Resistance Index ◽  
Gestational Trophoblastic Disease ◽  
Uterine Wall ◽  
Uterine Tissue ◽  
Trophoblastic Disease ◽  
Trophoblastic Tissue

Transvaginal Doppler ultrasonography has an important role in detecting and confirming the gestational trophoblastic disease (GTD). It can also be helpful in early detection of the malignant cases of GTD such as the invasion and protrusion of trophoblastic tissue into the uterine wall. Ultrasonographic picture of the malignant GTD is also specific for the presence of prominent zones of vasculavization in the peritrophoblastic tissue, as well as in the uterine tissue in which malignant GTD is developed. Resistance Index (RI) values were measured at the level of blood vessels of peritrophoblastic tissue and of suspected zones in the uterine tissue to detect neovascularization, which followed the malignant process. Theca luteal cysts were often detected by Transvaginal Doppler ultrasonography.

scholarly journals Gestational choriocarcinoma with hemorrhagic pleural effusion

2010 ◽  
Vol 18 (3) ◽  
pp. 86-87
Author(s):  
Biljana Lazovic ◽  
Vera Milenkovic
Keyword(s):  
Pleural Effusion ◽  
Blood Vessels ◽  
Gestational Trophoblastic Disease ◽  
Common Site ◽  
Left Half ◽  
Trophoblastic Disease ◽  
Gestational Choriocarcinoma ◽  
Hemorrhagic Pleural Effusion ◽  
Timely Treatment ◽  
Trophoblastic Tissue

Gestational trophoblastic disease (GTD) consists of a spectrum of disorders that are characterized by an abnormal proliferation of trophoblastic tissue. By virtue of their high vascularity and affinity of trophoblast for blood vessels, metastases often occur early and the most common site of such metastases is the lung. We described a case of a 34-year-old patient with pain in the left half of the chest, occasional, brief hemoptysis, and amenorrhea occurring in the period of 3 months. This presentation highlights the importance of analysis of HCG in the pleural puncture, for quick diagnosis and timely treatment.

Choriocarcinoma – postdisease ultrasonographic findings

2004 ◽  
Vol 14 (4) ◽  
pp. 677-679
Author(s):  
B. Nikolic ◽  
R. Lukic
Keyword(s):  
Reproductive Health ◽  
Ultrasound Examination ◽  
Resistance Index ◽  
Gestational Trophoblastic Disease ◽  
Uterine Wall ◽  
Malignant Tissue ◽  
Uterine Tissue ◽  
Degree Of Malignancy ◽  
Malignant Trophoblast ◽  
High Degree

This is a case report of consequences that malignant gestational trophoblastic disease (GTD) can cause on reproductive health protruding into uterine wall and damaging uterine tissue. Transvaginal Doppler ultrasound examination can be of great value in detecting molar tissue, protrusion of malignant trophoblast in uterine wall, and neovasularization in malignant tissue. It is expected to measure a low resistance index in a field of neovascularization, because neovascularization in malignancy is not rare and those vessels do not have muscular stratum. This case is an example of possible irreversible serious and large damages that can be seen after successful treatment of GTD. They are warning on possible high degree of malignancy in GTD as well as on possible serious impact on reproductive health.

scholarly journals Understanding and management of gestational trophoblastic disease

F1000Research ◽  
2019 ◽  
Vol 8 ◽  
pp. 428 ◽  
Author(s):  
Fen Ning ◽  
Houmei Hou ◽  
Abraham N. Morse ◽  
Gendie E. Lash
Keyword(s):  
Risk Factors ◽  
Treatment Options ◽  
Gestational Trophoblastic Disease ◽  
Abnormal Development ◽  
Trophoblastic Disease ◽  
Trophoblastic Tissue

Gestational trophoblastic disease or neoplasia covers a spectrum of benign and malignant conditions arising from pregnancies with highly abnormal development of trophoblastic tissue. In this brief review, we discuss the different features of these different conditions and their origins and risk factors and introduce some of the more novel and controversial treatment options currently being explored.

scholarly journals OP21.02: Doppler ultrasonography in assessment of gestational trophoblastic disease

2006 ◽  
Vol 28 (4) ◽  
pp. 506-506
Author(s):  
M. Onofriescu ◽  
D. Nemescu ◽  
M. Tirnoveanu ◽  
D. Dragomir
Keyword(s):  
Doppler Ultrasonography ◽  
Gestational Trophoblastic Disease ◽  
Trophoblastic Disease

Doppler study of myometrium in invasive gestational trophoblastic disease

2004 ◽  
Vol 14 (5) ◽  
pp. 972-979 ◽  
Author(s):  
S. Oguz ◽  
A. Sargin ◽  
H. Aytan ◽  
S. Kelekci ◽  
H. Dumanli
Keyword(s):  
Color Doppler ◽  
Single Agent ◽  
Resistance Index ◽  
Myometrial Invasion ◽  
Total Abdominal Hysterectomy ◽  
Abdominal Hysterectomy ◽  
Color Doppler Ultrasound ◽  
Gestational Trophoblastic Disease ◽  
Trophoblastic Disease ◽  
Doppler Study

ObjectiveIn this prospective study, we aimed to assess the prognostic and diagnostic role of color Doppler flow of myometrium in patients with invasive gestational trophoblastic disease (GTD).MethodsThirty-seven patients, who were enrolled in the study with invasive mole, were assessed with the help of transvaginal color Doppler ultrasound before and after chemotherapy. The place and the size of the myometrial invasions were assessed.ResultsThirty patients of 37 were treated with the help of single-agent chemotherapy – methotrexate (mtx). In this group, the resistance index (RI) ratios ranged between 0.26 and 0.45 and the size of the myometrial invasion varied between 10 and 50 mm. On the other hand, six patients were treated with mtx and actinomycin D combination and one patient was treated with the help of total abdominal hysterectomy. In this group, the RI ratios ranged between 0.16 and 0.25 and the size of the myometrial invasion varied between 60 and 90 mm. Remission was achieved in all patients.ConclusionTransvaginal color Doppler study can easily detect invasive GTD. When the depth and the width of the myometrial invasion increase and when there is a low diastolic/systolic ratio, the number of courses and the need for combination of chemotherapy increase.

scholarly journals Does hysteroscopy in women with persistent gestational trophoblastic disease reduce the need for chemotherapy? A prospective, single-arm, clinical trial pilot study

2021 ◽  
Vol 18 (1) ◽  
Author(s):  
Fatemeh Davari Tanha ◽  
Saghar Samimi Sede ◽  
Fariba Yarandi ◽  
Elham Shirali ◽  
Maliheh Fakehi ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Hydatidiform Mole ◽  
Gestational Trophoblastic Disease ◽  
Trophoblastic Disease ◽  
Beta Hcg ◽  
Significant Difference ◽  
History Of ◽  
The Mean ◽  
Trophoblastic Tissue

Abstract Background This study aimed to describe the efficacy of hysteroscopy in the management of women with the persistent gestational trophoblastic disease (PGTD)/GTN to reduce the need for chemotherapy. Materials and methods This prospective, single-arm, clinical trial study was recruited in an educational referral hospital between September 2018 and September 2019. Totally, 30 participants with a history of hydatidiform mole that was managed by uterine evacuation and developed low risk persistent gestational trophoblastic disease were recruited. Hysteroscopy was performed for removal of persisted trophoblastic tissue. Serum beta-hCG titer was measured before and 7 days after the procedure. Results The mean ± SD age of the participants was 31.4 ± 4.6 years. There was a significant difference (p = 0.06) between that mean ± SD of beta-hCG titer before (8168.4 ± 1758) and after (2648.8 ± 5888) hysteroscopy. Only two (6.6%) cases underwent chemotherapy due to no drop in the beta-hCG titer. Conclusion Hysteroscopy may play a significant role in the management of GTN, although it requires validation in larger prospective randomized studies and longer follow-up.

scholarly journals Hyperthyroidism in gestational trophoblastic disease – a literature review

2021 ◽  
Vol 14 (1) ◽  
Author(s):  
Jarett Vanz-Brian Pereira ◽  
Taylor Lim
Keyword(s):  
Risk Factors ◽  
Early Detection ◽  
Gestational Trophoblastic Disease ◽  
Thyroid Stimulating Hormone ◽  
Cochrane Library ◽  
Thyroid Storm ◽  
High Risk Women ◽  
Trophoblastic Disease ◽  
Full Text Review ◽  
Thyrotropic Activity

Abstract Objective Gestational trophoblastic disease (GTD) is a group of pregnancy-related disorders that arise from abnormal proliferation of placental trophoblast. Some patients with GTD develop hyperthyroidism, a rare but potentially life-threatening complication requiring early detection and management. Existing literature on hyperthyroidism in GTD is scant. This review aims to analyse the epidemiology, pathophysiology and management of this phenomenon. Methods A comprehensive search of MEDLINE, EMBASE and Cochrane Library was performed to obtain articles that explored hyperthyroidism in GTD. A total of 405 articles were screened and 228 articles were considered for full-text review. We selected articles that explored epidemiology, pathophysiology and outcomes/management of hyperthyroidism in GTD. Results The pathophysiology of hyperthyroidism in GTD is well-investigated. Placental trophoblastic tissue secretes excessive hCG, which is structurally similar to thyroid stimulating hormone and also has enhanced thyrotropic activity compared to normal hCG. The incidence and prevalence of hyperthyroidism in GTD varies worldwide, with lower rates associated with high uptake of early antenatal screening and early GTD detection. No clear risk factors for hyperthyroidism in GTD were identified. While hyperthyroidism can be definitively managed with surgical evacuation of the uterus, severe complications associated with hyperthyroidism in GTD have been reported, including thyroid storm-induced multi-organ failure, ARDS, and pulmonary hypertension. Conclusion Early detection of GTD is critical to prevent development of hyperthyroidism and its associated complications. Hyperthyroidism should be recognised as an important perioperative consideration for women undergoing surgery for GTD, and requires appropriate management. Future studies should explore risk factors for hyperthyroidism in GTD, which may facilitate earlier identification of high-risk women.

scholarly journals Characteristics of Three-Dimensional Power Doppler in Gestational Trophoblastic Disease

2015 ◽  
Vol 2015 ◽  
pp. 1-6 ◽  
Author(s):  
Wei Wang ◽  
Xueye Tian ◽  
Ting Zhang ◽  
Yanyan Wang ◽  
Zhen Han ◽  
...  
Keyword(s):  
Hydatidiform Mole ◽  
Power Doppler ◽  
Three Dimensional ◽  
Resistance Index ◽  
Gestational Trophoblastic Disease ◽  
Flow Index ◽  
Three Dimension ◽  
Trophoblastic Disease ◽  
Significant Difference ◽  
Vascularization Index

Purpose. In the present study, the three-dimensional power Doppler was used as a quantitative method to evaluate its reliability in detecting and assessing of gestational trophoblastic disease (GTD).Methods. 52 GTD patients who received diagnosis and treatment at the first affiliated hospitals of Xi’an Jiaotong University in China between 2011 and 2013 were evaluated using Voluson E8 (GE Medical System). Demographic information, pathological characteristics, clinical history, sonographic images, and related indices (resistance index, vascularization index, and flow and vascularization index) were evaluated.Result. Three-dimension power Doppler indicated that there were significant differences in the resistance index, vascularization index, flow index, and vascularization-flow index between the healthy individuals and each subgroup of patients (P<0.01). Further, in combining invasive hydatidiform mole and choriocarcinoma groups, there was a significant difference between hydatidiform mole and the combined malignant group (P<0.01). And the abnormal sonographic and power Doppler findings in GTD were resolved when chemotherapy was done successfully.Conclusion. Combined with the clinical features, sonography and three-dimension power Doppler imaging were helpful in diagnosing GTD as a noninvasive method, distinguishing the invasive nature of disease, detecting the recurrence of the disease, and assessing the effectiveness of the chemotherapy.

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