Molar Pregnancy and GTN (Gestational Trophoblastic Neoplasia)

A molar pregnancy is an abnormal pregnancy in which the placenta develops incorrectly and cannot result in a viable baby.

At Hadassah Medical Center, we have extensive experience in the diagnosis, follow-up, and treatment of molar pregnancy and GTN, with close multidisciplinary care and excellent outcomes.

Key Facts

• How common: About 1 in 500–1,500 pregnancies
• Who is at risk: More common at the extremes of reproductive age (younger than 20 or older than 35–40), in women with a prior molar pregnancy, and in certain geographic populations, though it can occur in any pregnancy

Symptoms and Diagnosis

• Symptoms: Often excessive nausea and vomiting, sometimes vaginal bleeding or abdominal pain, and occasionally no symptoms
• Ultrasound findings: Typical appearance suggesting molar pregnancy
• Blood tests: Elevated beta-hCG levels higher than expected for gestational age
• Types:
• Complete mole: No normal fetus; abnormal placental tissue only.
• Partial (incomplete) mole: Abnormal placenta with some fetal tissue, but not a viable pregnancy.

Treatment

• There is no possibility of a viable pregnancy
• Treatment involves uterine evacuation (D&C) performed by an experienced physician
• Tissue is sent for pathological confirmation

Follow-Up (Essential)

• Beta-hCG blood tests weekly until normalization
• Then monthly follow-up for 3 (incomplete mole)–6 months (complete mole)
• Reliable contraception is recommended during this period

When is GTN Diagnosed?

• hCG levels rise, plateau, or fail to decline
• New symptoms or findings appear

Additional Evaluation

• Ultrasound and CT scans are used to assess for spread
• A risk score (based on hCG level, age, molar type, timing, and extent of disease) determines treatment intensity

Treatment of GTN

• Low-risk disease: single-drug chemotherapy
• High-risk disease: combination chemotherapy
• Surgery: hysterectomy may be considered in selected patients who have completed childbearing

Side Effects

• Chemotherapy may cause nausea, fatigue, hair loss, and temporary effects on fertility, which are usually reversible

Prognosis

• GTN is highly treatable, with excellent cure rates, even in cases where the disease has spread

Important

After a molar pregnancy, or if abnormal hCG levels are detected, it is important to seek prompt evaluation and follow-up.

We are here to guide and support you throughout diagnosis, treatment, and recovery.

To schedule an appointment, please contact us via email at: [email protected]

Palliative Care in Gynecologic Oncology

• Purpose:
• Focuses on relieving symptoms, improving quality of life, and supporting patients and families through the cancer journey.
• Can be provided at any stage of illness, not just at the end of life.
• Who can benefit:
• Patients with advanced or recurrent gynecologic cancers
• Patients undergoing intensive treatment who experience side effects
• Families and caregivers needing emotional, social, or practical support
• Symptoms and challenges addressed:
• Physical: pain, nausea, vomiting, fatigue, shortness of breath, sleep problems, loss of appetite, swelling, lymphedema paracentesis (ascites drainage) and thoracentesis (pleural effusion drainage) to alleviate discomfort, and management of oncological wounds.
• Emotional: anxiety, depression, fear, stress, coping with diagnosis
• Social & practical: help with daily activities, care coordination, financial or logistical support
• Spiritual: support for personal beliefs and values
• Care team:
• We provide Multidisciplinary approach including doctors, nurses, social workers, psychologists/counselors, nutritionists, and more.
• Team works together to create a personalized plan based on each patient’s needs
• Benefits of palliative care:
• Symptom relief and improved comfort
• Better coping with cancer treatments and side effects
• Maintaining independence and daily functioning
• Support for family members in caring for the patient and managing stress
• Assistance with decisions, including treatment choices and advance care planning
• Integration with treatment:
• Can be provided alongside active cancer therapy, such as surgery, chemotherapy, or radiotherapy
• Helps patients continue treatment more comfortably with fewer interruptions
• Early involvement has been shown to improve outcomes and wellbeing
• Additional services:
• Guidance on home care, hospice, or hospital support if needed
• Education on symptom management at home
• Emotional counseling, support groups, and practical resources

For >> more information