Research Article

Gestational Trophoblastic Disease with Coexisting Progressing Pregnancy: Personalised Treatment Modalities

Table 1

Description of pregnant women with GTD and management and outcomes of GTD after pregnancy.

CaseAge (y)Obstetric anamnesisTime of GTD detection (GW)P typeP outcomeUltrasound dataMRI dataHistological formβ-hCG titer (3 weeks postnatal follow-up)Presence of metastatic lesions (localization)Treatment

N131P-011Singleton pregnancyTermination of pregnancy for obstetrical/medical reasonsHyperechogenic reticular, cellular structure. Retrochorial hematoma.Multicystic pathological formation, numerous vessels. The contact area is uneven, indistinct. Retroplacental vascularization/neovascularization. Adhesion areas (5.0–5.5 cm). Subchorionic hematoma. Mild collateralization.Invasive molePlateauPulmonaryChemotherapy Mtx/FA, dactinomycin

N236P-4, A-1, D-3, Ln-310Diamniotic dichorionic twinsChildbirth 27 GWHyperechogenic formation of heterogeneous structure with anechogenic multifaceted inclusions. Retrochorial hematoma.The lower amniotic cavity and placenta are replaced by pathological tissue of heterogeneous cystic structure. Contours indistinct, rough, infiltration of the anterior uterine wall. Collateralization in the inferior segment. Retroplacental vascularization/neovascularization. Subamniotic hematoma.Choriocarcinoma in one placentaPlateauPulmonaryChemotherapy Mtx/FA

N332P-2, A-1, D-1, Ln-116Singleton pregnancyChildbirth 28 GWOne-third of the placenta with cystic inclusions. Subamniotic hematoma.Cellular structures of irregular shape. The surface of the placenta is rough, with a lumpy contour. Retroplacental and intramural vascularization.Intraplacental choriocarcinomaPlateauPulmonaryChemotherapy Mtx/FA

N436P-019Diamniotic dichorionic twinsChildbirth 33 GWThe formation of a cellular structure.Placental overgrowth in the form of cysts of various diameters.Noninvasive mole of a single fetusNormalisationAbsentNone, observation

N531P-1, D-1, Fd-111Diamniotic dichorionic twinsTermination of pregnancy for medical reasonsFormation of a cellular structure. Theca lutein cysts. Subamniotic hematoma.Multicystic masses surround the amniotic cavity, subtotally filling the uterine cavity. Majority parts of both placentas are represented by pathological multicystic structures. Subamniotic hematoma. The boundaries with myometrium are clear, smooth. Theca lutein cysts.Noninvasive mole of both fetusesNormalisationAbsentNone, observation

P, pregnancy; D, deliveries; A, abortion; Ln, live newborns; Fd, fetal death; GW, gestational weeks; Mtx, methotrexate; FA, folinic acid.