THERAPEUTIC APPROACH FOR GESTATIONAL TROPHOBLASTIC DISEASE

Abstract

Objective: To comprehensively discuss the therapy of Gestational Trophoblastic Disease (GTD). Methodology: Integrative review of the literature carried out in the Virtual Health Library (VHL), Google Scholar and PubMed databases, using the descriptors in Health Sciences (DeCS): “Pregnancy”, “Gestational Trophoblastic Disease” and “Treatment” combined between si by the Boolean operator AND. Results: Gestational trophoblastic disease (GTD) is a rare group of conditions affecting placental trophoblastic cells, including hydatidiform mole and gestational choriocarcinoma. Its incidence varies globally, occurring in approximately 1 to 1.5 pregnancies per 1,000. Factors such as maternal age, obstetric history and ethnicity influence its prevalence, with a higher risk in young or older women and with a history of anomalous pregnancies. Early recognition is crucial, considering symptoms such as vaginal bleeding, abnormal enlargement of the uterus, hypertension, and respiratory signs indicative of lung metastases. The therapeutic approach varies depending on the type of DTG. In hydatidiform mole, uterine evacuation is common. In choriocarcinoma, chemotherapy is central, whereas persistent trophoblastic disease may require chemotherapy, surgery, or both. The approach must include emotional and psychological support, involving a multidisciplinary team to ensure appropriate, patient-centered management. The increased incidence in certain areas may be due to more accurate diagnoses and changes in risk factors such as maternal age and the use of assisted reproductive techniques. Conclusion: Effective management of GTD demands early recognition, an individualized therapeutic approach and emotional support, highlighting the importance of continuous education and prevention.