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Gestational Trophoblastic Disease: A Clinical Review and Case Study Presentation for the Advanced Practice Nurse
1Merlendi Brown.
Background:
Gestational trophoblastic (GT) disease is a continuum of gynecologic disorders that begins with a hydatidiform mole and may progress to GT neoplasia.
Objectives:
The purpose of this article is to review the pathophysiology and clinical manifestations associated with GT disease and provide the advanced practice RN with evidence-based management strategies to use when caring for patients.
Methods:
A case study details a woman aged 42 years with a hydatidiform mole who underwent multiple uterine curettage procedures. The disease progressed to GT neoplasia, characterized by elevated human chorionic gonadotropin (hCG) levels. The patient completed a 10-week course of IV methotrexate, and hCG levels returned to normal range.
Findings:
Serial monitoring of hCG levels is paramount when caring for a patient with GT disease. The advanced practice RN should recognize the pathologic significance of rising hCG levels, report these trends to the treating physician, and aim to improve health outcomes.
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