ABSTRACT
Gestational trophoblastic disease (GTD) has a broad spectrum of biological behavior of the abnormal trophoblast from hydatidiform moles that remit spontaneously following evacuation of the uterine cavity to highly aggressive tumors of widely metastasising potential, which are usually pathologically choriocarcinoma. GTD can follow any form of pregnancy including normal pregnancy, but the most common antecedent conception is a hydatidiform mole. The incidence of GTD following a normal pregnancy is of the order of 1 in 40,000-50,000 pregnancies, but complete hydatidiform moles have an incidence in the United Kingdom of approximately 1 in 1200 pregnancies. GTDs are clearly uncommon conditions and, in the United Kingdom, there is a national service for women with this condition. Under the auspices of the Royal College of Obstetricians andGynaecologists and the Supraregional Specialties run by the Department of Health, there are three reference centers for registering patients for serial human chorionic gonadotrophin (hCG) estimations, and these are based at Dundee, Sheffield, and the Charing Cross Hospital in London. At present, approximately 1400 women are registered at the three centers per annum and around 120 patients will need chemotherapy to eliminate their GTD at the two treatment centers, which are based at the Charing Cross Hospital in London and Weston Park Hospital in Sheffield. This national service allows the accumulation of great expertise and experience in treating this rare group of diseases and with proper management it is uncommon for any woman to die of her GTD in the United Kingdom (1).
