Gestational Trophoblastic Disease: Causes, Symptoms, and Treatment
Medically reviewed by Harsha Moole, MD, Internal Medicine. Last reviewed: October 23, 2026.
What kind of doctor treats Gestational Trophoblastic Disease?
An OB-GYN (a doctor who cares for pregnancy and the female reproductive system) usually leads care. A gynecologic oncologist (a doctor who treats cancers of the female reproductive organs) may also be involved. A direct primary care or concierge doctor can be a first stop for an evaluation and can refer you to a specialist when needed.
What is gestational trophoblastic disease?
Gestational trophoblastic disease (GTD) is a group of pregnancy-related conditions. The abnormal cells start in the tissue that would normally become the placenta. The placenta feeds the fetus, which is the unborn baby. In most cases, only placental tissue forms. In rare cases, a fetus may also form.
GTD is a general term for rare tumors. Most GTD is benign and does not spread. Some types can become cancer. The main types are:
- Hydatidiform mole, also called a molar pregnancy. It is the most common type. Most hydatidiform moles are benign, which means not cancer.
- Invasive mole. This form grows into the muscle wall of the uterus (womb). It can spread to other parts of the body.
- Choriocarcinoma. This is a rare but aggressive cancer. It can spread to the brain, lungs, liver, and other organs.
- Placental-site trophoblastic tumor. This very rare type forms where the placenta attaches to the uterus.
- Epithelioid trophoblastic tumor. This very rare type may be benign or cancer.
Symptoms
The most common sign is abnormal vaginal bleeding. GTD sometimes causes an overactive thyroid gland. Check with your doctor if you have any of the following:
- Vaginal bleeding that is not related to a period.
- A uterus that is larger than expected during pregnancy.
- Pain or pressure in the pelvis, the lower part of the belly between the hips.
- Severe nausea and vomiting during pregnancy.
- High blood pressure with headache and swelling of the feet and hands early in pregnancy.
- Vaginal bleeding that continues for longer than normal after delivery.
- Anemia, a low count of red blood cells, can cause tiredness, shortness of breath, dizziness, or a fast or irregular heartbeat.
A blood test may show abnormally high levels of hCG, a hormone made during pregnancy. An overactive thyroid can cause a fast heartbeat, shakiness, and weight loss.
Causes and who gets it
Doctors do not know the exact cause of hydatidiform moles. In a complete mole, sperm fertilizes an egg. That egg has no DNA from the mother. In a partial mole, a normal egg is fertilized, and it has two sets of DNA from the father.
Risk factors include:
- A past molar pregnancy, also called a personal history of hydatidiform mole.
- A pregnancy before age 20 or after age 35.
How doctors diagnose it
Doctors start with a physical exam and a pelvic exam. The pelvic exam checks the vagina, cervix, uterus, fallopian tubes, and ovaries. An ultrasound uses high-energy sound waves to make a picture of the pelvis. Blood tests measure beta-hCG, a hormone made during pregnancy.
Treatment
Treatment depends on the specific type and risk category. It also depends on whether you want to become pregnant in the future.
Most hydatidiform moles are treated with a minor surgical procedure. The usual procedure is dilatation and curettage with suction evacuation, also called D&C. The cervix, the opening of the uterus, is widened. A small vacuum-like device removes the tissue. It is used inside the uterus.
After surgery, beta-hCG blood tests are done every week until the level returns to normal. Follow-up visits happen monthly for up to 6 months. A level that does not return to normal or goes up may mean the mole was not completely removed and has become cancer. Your doctor will ask you not to become pregnant until follow-up is finished.
If disease remains after surgery, chemotherapy is usually the next step. Chemotherapy uses drugs to stop cancer cells from growing or dividing.
Surgery can also treat tumors that do not respond to chemotherapy. A hysterectomy, surgery to remove the uterus, may be one choice.
When to see a doctor
Check with your doctor if you have vaginal bleeding that is not related to a period. Also check if your uterus seems larger than expected during pregnancy.
Call 911 or go to the emergency room if you have severe trouble breathing, fainting, or heavy bleeding that will not stop. Also call 911 for a seizure, a sudden vision change, or a sudden severe headache.
How a direct primary care or concierge doctor fits in
A direct primary care doctor charges a flat monthly fee instead of billing insurance, while a concierge doctor usually charges more and often works alongside insurance. A doctor like this can help with the first evaluation and the follow-up blood tests. This doctor can also help coordinate care with specialists when treatment is needed.
Common questions
Is gestational trophoblastic disease cancer?
Some types are cancer, and most are not. Most GTD is benign, which means it is not cancer and does not spread.
Can gestational trophoblastic disease be cured?
Yes, it usually can be cured. The outlook is generally good. Careful checks after treatment help find any return of the disease.
Will I need blood tests after treatment?
Yes. After surgery, beta-hCG blood tests are done every week until the level is normal. Visits then happen monthly for up to 6 months. A high level may mean the tumor has not responded to treatment or has become cancer.
Sources
- MedlinePlus Medical Encyclopedia - Gestational trophoblastic disease
- National Cancer Institute - Gestational Trophoblastic Disease, Patient Version
- National Cancer Institute - Gestational Trophoblastic Disease Treatment (PDQ), Patient Version
Medical Disclaimer
This content is for general educational and informational purposes only and is not medical advice. It is not a substitute for professional medical advice, diagnosis, or treatment, and reading it does not create a doctor-patient relationship. Always seek the advice of your physician or another qualified health provider with any questions about a medical condition, and never disregard or delay seeking professional advice because of something you read here. If you think you may have a medical emergency, call 911 (or your local emergency number) immediately.
