Quiescent trophoblastic disease

SOGC/GOC Clinical Guideline #408, January 2021

Patients with quiescent GTD have hCG levels around 55 IU/L and do not need active management other than regular hCG monitoring.
Pituitary hCG production averages 10–11 IU/L (menopause) and < 35 IU/L (perimenopause) and can be normalized by administering an oral contraceptive containing estrogen for 3 weeks.
Phantom hCG is a false positive assay result caused by circulating heterophile antibodies (blood + and urine -).
In the absence of pregnancy or signs of malignancy, women with persistently elevated serum and urinary hCG levels should be followed long term.
1 in 5 women in this group will have GTN several months or years after the initial manifestation.
It is recommended to avoid treatment in the absence of clearly established disease.

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 12/23/2023