Complete molar pregancy with development of non-metastatic persistent trophoblastic disease
A case report, reflection of rules of care and decision-making processes Forensic responsibility and the position of doctor in the general gynecologic and obstetric outpatient practice


Authors: S. Zeman 1;  P. Trávník 2;  K. Dvořáková 3;  J. Zemanová 1
Authors‘ workplace: Gynekologicko-porodnická ambulance, Velké Meziříčí, MUDr. S. Zeman 1;  REPROMEDA, Centrum reprodukční medicíny a preimplantační diagnostiky, Brno, ředitelka MUDr. K. Veselá Ph. D. 2;  Patologicko-anatomické oddělení nemocnice, Jihlava, prim. MUDr. M. Kheck 3
Published in: Ceska Gynekol 2017; 82(5): 396-406

Overview

Objective:
To define the forensic responsibility and the position of doctor in the general gynecologic and obstetric outpatient practice in care of the complete molar pregancy.

Design:
Case report and review article.

Setting:
General gynecologic and obstetric outpatient practice Velké Meziříčí; Sanatorium REPROMEDA, Centre of reproductive medicine and preimplantation genetics, Brno; Histopatology department of Hospital Jihlava.

Case report:
The changing clinical presentation of complete molar pregnancy with development of non-metastatic gestational trophoblastic disease: management. Subsequent early pregnancies outcome following complete hydatiform molar pregnancy.

Discussion:
Discussed are the forensic responsibility and the position of doctor in the general gynecologic and obstetric outpatient practice with the collaboration of Trophoblastic Disease Center based on the detail expert knowledges: rules of care and decision-making processes and potential controversies, the pitfalls of the histopathologic diagnosis, the genetics of complete hydatiform mole: new lights on a disease, outpatient follow-up and possibility and the risks of the subsequent pregnancy.

Conclusion:
The conclusion is trying to guide quickly a doctor in the general gynecologic and obstetric outpatient practice in the decision-making processes through the crossings of any situation of the complete molar pregnancy and outpatient follow-up, alternatively with the collaboration of Trophoblastic Disease Center.

Keywords:
complete hydatiform mole, persistent gestational trophoblastic disease/neoplasia, GTN, chemotherapy, general gynecologic and obstetric outpatient practice, Trophoblastic Disease Center, molar pregnancy, trofoblast, genetics, outpatient follow-up, forensic responsibility


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Paediatric gynaecology Gynaecology and obstetrics Reproduction medicine

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