PERSISTENT GESTATIONAL TROPHOBLASTIC DISEASE
Definition- Persistent GTD is defined where there is persistence of Trophoblastic activity as evidenced by clinical, imaging, pathological, and or hormonal study following initial treatment.
-This may be following the treatment of hydatidiform mole, invasive mole, choriocarcinoma, or placental site Trophoblastic Tumour.
-A postmolar GTD may be benign or malignant. But a GTD after non-molar pregnancy is always a Choriocarcinoma.
-Overall incidence of persistent GTN after complete hydatidiform moles is 15-20%.
-Approximately 50 percent of the cases develop following a hydatidiform mole, 25 percent following an abortion or ectopic pregnancy and another 25 percent following normal pregnancy.
DIAGNOSIS- This state is diagnosed during post evacuation follow up period.
THE DIAGNOSTIC FEATURES ARE: -
HCG titres either fail to become negative or remain plateau or there is re-elevation after an initial fall by 8 weeks post molar evacuation. Local or systemic metastases should always be excluded (X-ray chest, CT, MRI of brain and liver).
Asymptomatic patients with a normal chest X-ray, is unlikely to have brain or other visceral metastases.
Pathologically this may be due to invasive mole, choriocarcinoma, or placental site trophoblastic tumour.
Regardless of the histological diagnosis, the therapeutic approach is almost the same. The prognosis is usually good.
Patients are classified into low or high risk categories.
Hysterectomy, this is justified in women approaching 40 and/or who has completed her family.
HOMOEOPATHIC MEDICINES FOR PERSISTENT GESTATIONAL TROPHOBLASTIC DISEASE: -
1) ARSENICUM ALBUM:
2) CARBOLIC ACID: -
3) FERRUM MET: -
4) PHOSPHORUS: -
5) SEPIA: -
6) COCCULUS INDICA: -