What Is Gestational Trophoblastic Disease (GTD)? Rare Pregnancy-Related Tumors — Explained
Updated: 2 days ago
Medically reviewed by Dr. Baraa Alnahhal, MD · Last reviewed: October 17, 2026
Quick Answer
Gestational trophoblastic disease (GTD) is a rare group of conditions in which abnormal tumors grow in the womb during pregnancy instead of a healthy placenta, most commonly a molar pregnancy. Most forms are benign and highly treatable with a D&C or chemotherapy, after diagnosis by hCG blood tests and ultrasound. Most people recover fully and can have normal pregnancies.
Key Takeaways
What it is: Rare tumors growing in the uterus instead of a healthy placenta.
Most common type: Molar pregnancy (hydatidiform mole).
How common: About 1 in 1,000 pregnancies in the United States.
Cancer risk: Most are noncancerous; rare forms (like choriocarcinoma) are cancerous.
Main symptom: Abnormal vaginal bleeding early in a suspected pregnancy.
Key diagnostic marker: Abnormally high hCG (pregnancy hormone) levels.
Primary treatment: Dilation and curettage (D&C) surgery to remove the tissue.
Future outlook: Excellent; most people can have healthy pregnancies afterward.
Recurrence: Can come back; regular hCG monitoring is required after treatment.
Risk factors: Age (under 20 or over 35) and prior history of molar pregnancy.
What the research says
Future pregnancies: In the New England Trophoblastic Disease Center series of 2,432 subsequent pregnancies (1,388 after complete mole, 357 after partial mole, 667 after gestational trophoblastic neoplasia), outcomes were similar to the general population. About 1.7% had a molar pregnancy in a later pregnancy, and stillbirth was slightly higher (1.3%) after successful chemotherapy for GTN [6].
Fertility after treatment: A systematic review found that single-agent chemotherapy does not affect fertility or subsequent pregnancy outcome, miscarriage is more common when conception occurs within 6 months after chemotherapy, and subsequent pregnancies have a high chance of ending with live, healthy babies [7].
Ultrasound: A meta-analysis found ultrasound had a relatively low sensitivity (52.2%) but high specificity (92.6%) for hydatidiform mole, with histological examination remaining the gold standard [8].
What Is Gestational Trophoblastic Disease?
Gestational trophoblastic disease (GTD) refers to a group of tumors that start in the uterus (womb) related to pregnancy [1]. These tumors begin in cells called trophoblasts, which normally develop into the placenta, the organ that connects a fetus to the uterine wall to provide oxygen and nutrients [1] [4].
In GTD, the trophoblasts grow abnormally, forming tumors or grape-like cysts instead of a healthy, functioning placenta [1]. While these conditions are called "pregnancies" (such as a molar pregnancy), the abnormal cells do not develop into a baby [1].
What are the types of gestational trophoblastic disease (GTD)?
Gestational trophoblastic disease (GTD) is not a single condition but a group of related disorders linked to pregnancy. They range from benign (noncancerous) to malignant (cancerous) forms [1] [3]:
Type | Description | Cancer Status |
Hydatidiform Mole | The most common form, often called a "molar pregnancy." Grape-like cysts grow in the uterus. | Usually Benign |
Invasive Mole | A molar pregnancy that grows into the muscular wall of the uterus. | Typically Cancerous |
Choriocarcinoma | A fast-growing cancer that can spread to the lungs, brain, and liver. | Cancerous |
PSTT | A very rare tumor that forms where the placenta attaches to the uterus. | Rare/Cancerous |
ETT | An extremely rare form that can spread to the lungs years after a pregnancy. | Rare/Cancerous |
What are the symptoms of gestational trophoblastic disease?
Some people with GTD have no symptoms at all, while others experience signs that mimic a typical pregnancy or other conditions [1]. Common symptoms include:
Abnormal vaginal bleeding: The most frequent sign, often red or watery brown bleeding early in a suspected pregnancy [1].
Uterine size: The uterus may measure much larger than expected for the stage of pregnancy.
Pain: Pelvic or abdominal pain or pressure.
Severe nausea: Nausea and vomiting that is earlier or more intense than typical "morning sickness."
Preeclampsia signs: High blood pressure or swelling in the hands and feet very early in pregnancy [1].
Thyroid signs: An overactive thyroid (hyperthyroidism) causing a fast heartbeat, sweating, or shakiness [1].
What causes gestational trophoblastic disease, and who is at risk?
GTD happens when the fertilization process does not occur correctly [1]. In a normal pregnancy, an egg and sperm combine to create an embryo and a placenta. In GTD, the genetic information is incorrect, leading the trophoblast cells to grow into tumors instead of a healthy support system for a fetus [1] [5].
Who is at risk?
While GTD is rare, certain factors can increase the likelihood of developing the condition [1]:
Age: Being younger than 20 or older than 35 during pregnancy.
Prior history: Having had a molar pregnancy in the past.
Family history: A strong family history of molar pregnancies.
How is gestational trophoblastic disease diagnosed and staged?
Healthcare providers use several methods to diagnose GTD and determine if it has spread [1]:
Pelvic exam: To check for masses or an enlarged uterus.
Transvaginal ultrasound: Using sound waves to create a detailed picture of the uterus and pelvic organs [1].
hCG blood test: Measuring levels of the pregnancy hormone human chorionic gonadotropin (hCG). In GTD, these levels are often significantly higher than in a normal pregnancy [1].
Imaging for staging: If cancer is suspected, providers use CT scans, MRIs, or chest X-rays to see if cells have spread to the lungs or other organs [1].
What are the treatment options for gestational trophoblastic disease?
Treatment for GTD depends on the type, the stage of the disease, and whether the patient wishes to have children in the future [1] [2]:
Treatment | How It Works |
Surgery (D&C) | A dilation and curettage (D&C) removes abnormal tissue from the uterus. |
Chemotherapy | Drugs used to destroy cancer cells, especially for invasive moles or choriocarcinoma. |
Hysterectomy | Surgical removal of the uterus, often used if childbearing is complete or for aggressive cases. |
Radiation | Energy beams used to kill cancer cells (rarely used for GTD). |
Post-Treatment Monitoring
After the abnormal tissue is removed, it is critical to have regular blood tests to monitor hCG levels [1]. If these levels stay high or begin to rise, it may mean that some abnormal cells remain or the disease has returned [1].
What is life like after gestational trophoblastic disease (GTD)?
The prognosis for most people with GTD is excellent [1]. Most cases are cured, and the vast majority of people can go on to have normal, healthy pregnancies afterward [1] [6].
Important note: Providers usually recommend waiting a certain period (often 6 to 12 months) after hCG levels return to normal before trying to conceive again, to ensure the disease does not return [1].
Conclusion
Gestational trophoblastic disease is a rare and often frightening diagnosis, but it is highly treatable and usually curable [1]. Whether it is a common molar pregnancy or a more aggressive form like choriocarcinoma, early diagnosis and consistent follow-up care are the keys to a successful recovery. Most patients can look forward to a healthy future and successful pregnancies down the road.
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FAQ: Common Questions About GTD
What is gestational trophoblastic disease?
A group of rare tumors that grow in the uterus during pregnancy instead of a healthy placenta.
Is GTD a form of cancer?
Most cases (like molar pregnancies) are benign, but some forms are cancerous.
What is a molar pregnancy?
The most common type of GTD, where grape-like cysts grow in the womb.
Can a baby grow during a molar pregnancy?
No, the abnormal cells do not develop into a fetus.
How common is GTD?
It occurs in about 1 in every 1,000 pregnancies in the U.S.
What is the most common symptom?
Abnormal vaginal bleeding early in pregnancy.
Why is my uterus measuring large?
GTD tumors can cause the uterus to grow faster than a normal pregnancy would.
What is hCG?
A hormone produced during pregnancy; its levels are often very high in GTD.
How is GTD diagnosed?
Primarily through blood tests (hCG) and transvaginal ultrasounds.
What is a transvaginal ultrasound?
An ultrasound where the probe is inserted into the vagina for a clearer view of the uterus.
What is a D&C?
Dilation and curettage, a surgical procedure to remove abnormal tissue from the uterus.
Will I need chemotherapy?
Chemotherapy is used if the disease is cancerous or has spread.
Can GTD spread to other organs?
Yes, cancerous forms can spread to the lungs, brain, or liver.
What is choriocarcinoma?
A fast-growing, cancerous form of GTD.
Is GTD fatal?
Most cases are cured, but advanced, untreated cancerous GTD can be fatal.
Can I have a baby after GTD?
Yes, most people have normal pregnancies afterward.
How long should I wait to get pregnant again?
Most doctors recommend waiting 6 to 12 months.
Why do I need follow-up blood tests?
To make sure hCG levels fall to normal and the disease does not return.
Can GTD come back?
Yes, there is a risk of recurrence, which is why monitoring is vital.
What are the risk factors for GTD?
Being under 20 or over 35, and having a previous molar pregnancy.
Is GTD caused by something I did?
No, it is caused by a fertilization error beyond your control.
What is a complete molar pregnancy?
A molar pregnancy in which only abnormal placental tissue grows (no fetal tissue).
What is a partial molar pregnancy?
A molar pregnancy in which there is some fetal tissue along with abnormal placental tissue.
Can a partial mole become a baby?
No, the fetal tissue has too many chromosomes to survive.
What is an invasive mole?
A mole that grows into the muscle of the uterus.
What is PSTT?
Placental site trophoblastic tumor, a very rare form of GTD.
What is ETT?
Epithelioid trophoblastic tumor, another extremely rare form.
Does GTD cause morning sickness?
It can cause much more severe nausea and vomiting than normal.
Can GTD cause high blood pressure?
Yes, it can lead to early-onset preeclampsia.
Why does it affect the thyroid?
High hCG levels can sometimes mimic thyroid-stimulating hormones.
What are overactive thyroid symptoms?
Fast heartbeat, shakiness, and sweating.
Is a hysterectomy always necessary?
No, it is usually only for those who do not want more children or have aggressive cancer.
How is cancer staging done for GTD?
Using Roman numerals I through IV based on spread.
Are there support groups for GTD?
Yes, many organizations offer support for pregnancy loss and GTD.
What is the outlook for molar pregnancies?
Most are cured by removing the abnormal tissue, followed by regular hCG monitoring.
What is the outlook for choriocarcinoma?
Cure rates are high, even when it has spread, because it responds well to chemotherapy.
Can GTD occur after a normal birth?
Yes, though it is much less common than after a molar pregnancy.
Can GTD occur after a miscarriage?
Yes, it can follow any type of pregnancy event.
Is a positive pregnancy test always GTD?
No, but a positive test without a fetus on ultrasound is a major warning sign.
What does "trophoblastic" mean?
It refers to the trophoblast cells that form the placenta.
Does age really matter?
Yes, the risk is higher at the extremes of reproductive age.
Is GTD painful?
It can cause pelvic pressure or pain, especially if the uterus is enlarged.
Will I lose my hair during treatment?
Only if chemotherapy is required and the specific drug causes hair loss.
Can I still breastfeed?
If you have a normal pregnancy later, yes; during GTD treatment, it depends on the medications used.
How rare is PSTT?
It is considered extremely rare, occurring in only a tiny fraction of GTD cases.
What is gadolinium?
A contrast agent used in MRIs to help cancer cells show up more clearly.
Can GTD be prevented?
No, there is currently no known way to prevent it.
Is a molar pregnancy the same as a miscarriage?
They both involve pregnancy loss, but a molar pregnancy involves abnormal tumor growth.
Where can I find more information?
The National Cancer Institute and the Foundation for Women's Cancer are excellent resources.
References
Cleveland Clinic. Gestational Trophoblastic Disease. Cleveland Clinic. Last updated October 5, 2026. https://my.clevelandclinic.org/health/diseases/6130-gestational-trophoblastic-disease
Bruce S, Sorosky J. Gestational Trophoblastic Disease. In: StatPearls. Treasure Island (FL): StatPearls Publishing. Last update February 25, 2024. PMID 29261918. https://www.ncbi.nlm.nih.gov/books/NBK470267/
Canadian Cancer Society. Gestational trophoblastic disease. Canadian Cancer Society. Accessed October 30, 2026. https://cancer.ca/en/cancer-information/cancer-types/gestational-trophoblastic-disease
Foundation for Women's Cancer. Uterine/Endometrial Cancer/GTD (Gestational Trophoblastic Disease section). Foundation for Women's Cancer. Accessed October 30, 2026. https://foundationforwomenscancer.org/gynecologic-cancers/gynecologic-cancer-types/uterine-endometrial-cancer-gtd/
National Cancer Institute (U.S.). Gestational Trophoblastic Disease—Patient Version. National Cancer Institute. Accessed October 30, 2026. https://www.cancer.gov/types/gestational-trophoblastic
Vargas R, Barroilhet LM, Esselen K, et al. Subsequent pregnancy outcomes after complete and partial molar pregnancy, recurrent molar pregnancy, and gestational trophoblastic neoplasia: an update from the New England Trophoblastic Disease Center. J Reprod Med. 2014;59(5-6):188-194. PMID 24937955. https://pubmed.ncbi.nlm.nih.gov/24937955/
Joneborg U, Coopmans L, van Trommel N, et al. Fertility and pregnancy outcome in gestational trophoblastic disease. Int J Gynecol Cancer. 2021;31(3):399-411. PMID 33649007. https://doi.org/10.1136/ijgc-2020-001784
Newhouse I, Spacey A, Scragg B, et al. The diagnostic value and accuracy of ultrasound in diagnosing hydatidiform mole: a systematic review and meta-analysis of the literature. Radiography (Lond). 2022;28(4):897-905. PMID 35785640. https://doi.org/10.1016/j.radi.2022.06.005
Medical Disclaimer
This article is for informational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of a qualified healthcare provider with any questions about a medical condition. Never disregard professional medical advice or delay seeking care based on content you have read here.
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