Key messages

SOGC/GOC Clinical Guideline #408, January 2021

Anatomopathological examination of any product of conception that appears abnormal at the time of uterine evacuation and any pathology suggestive of GTD should be evaluated by a pathologist specializing in gynecology to differentiate CHM from PHM and to detect any signs of malignancy, as these distinctions will affect patient follow-up, treatment and referral.

The initial workup for post-molar GTNs should include a chest x-ray to detect any lung metastasis as well as a pelvic ultrasound to assess the extent of pelvic involvement. Initial workup for suspected CC, GTN after non-molar pregnancy, and/or post-molar GTN with lung metastases on chest x-ray should include pelvic ultrasound, chest and abdominal computed tomography (with hepatic arterial phase), and MRI imaging.

Women with a diagnosis of GTD should be referred to a gynecologist for an initial assessment, consideration for primary surgery (evacuation or hysterectomy), and follow-up.

It is recommended that women use a reliable contraceptive method throughout the follow-up period after a molar pregnancy.

Women with a diagnosis of GTN should be referred to a gynecologist-oncologist for tumor staging, risk scoring and consideration of primary surgery or systemic treatment (mono- or multi-drug therapy). ) and the need for any additional treatments.

2021. Guideline No. 408: Management of Gestational Trophoblastic Diseases. Eiriksson L, Dean E, Sebastianelli A, Salvador S, Comeau R, Jang JH, Bouchard-Fortier G, Osborne R, Sauthier Ph. J Obstet Gynaecol Can;43(1):91-105.

Modified on 12/22/2023