What are the symptoms of gestational trophoblastic disease?

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Gestational trophoblastic disease is not always easy to find. In its early stages, a hydatidiform mole may seem like a normal pregnancy.

Symptoms of gestational trophoblastic disease are:

  • vaginal bleeding (not menstrual bleeding)
  • a foetus not moving at the expected time during pregnancy
  • extremely severe morning sickness during pregnancy – this is caused by unusually high levels of the hormone human chorionic gonadotrophin (hCG)
  • a larger-than-usual uterus
  • high blood pressure with headache and swelling of feet and hands in the early stages of pregnancy
  • vaginal bleeding that continues for longer than normal after delivery (4–6 weeks)[1].

Some of these symptoms may only be detected by a doctor (such as a larger-than-usual uterus). You should see a doctor if you notice any of these symptoms.

Having these symptoms does not mean you have gestational trophoblastic disease. However, you should be examined by your regular doctor (GP) to investigate. If necessary, your doctor will refer you for tests.

Gestational trophoblastic neoplasia or placental-site trophoblastic tumours can occur after a hydatidiform mole, after an abortion or after a normal pregnancy and delivery. Therefore, some of these symptoms may appear during or after a pregnancy.

Early detection

In many cases, a hydatidiform mole will be detected during routine antenatal care during the first trimester of pregnancy. It may also be detected after a miscarriage.

After a molar pregnancy, your hCG levels will be closely monitored to detect any cells that remain. If the hCG level increases or does not go down to normal, more tests will be done to see whether the tumour has spread.

If you are not pregnant and hCG is detected in your blood, it can be a sign of gestational trophoblastic disease. You doctor will order more tests to investigate this.