Pregnancy Complications

GTD are diseases that arise from aberrant fertilization tissue within the maternal host and are identified early due to markedly elevated hCG levels and characteristic ultrasound findings. Uterine evacuation is the recommended treatment, while chemotherapy can be reserved for patients with recurrent disease or neoplastic GTD.

Pre-eclampsia is a condition that is characterized by an elevated blood pressure and proteinuria and that usually happens after 20 weeks of gestation. Women with pre-eclampsia can also develop hemolysis, thrombocytopenia and elevated liver enzymes known as HELLP syndrome or microangiopathic hemolytic anemia. Due to wide-spread endothelial dysfunction, they might also develop brain edema and eclampsia. Laboratory investigations show thrombocytopenia, proteinuria > 30 mg/day, hemolysis and elevated liver enzymes. The only known curative treatment for pre-eclampsia is delivery of the fetus.

Eccyesis or tubal pregnancy refers to the implantation of the blastocyst outside the uterine cavity. Thereby, affected patients suffer from acute abdominal pain. Eccyesis or tubal pregnancy can be quickly diagnosed by means of an ultrasound and laboratory analysis. In severe cases, in the case of rupture and hemorrhage, the fastest possible action is required. Surgery should be considered as a therapeutical approach.

During pregnancy, it is possible for the tissue surrounding the embryo to degenerate. Such degeneration typically manifests itself in hydatidiform moles and choriocarcinoma. These tumors are difficult to diagnose and are associated with an increased level of beta hCG. Treatment involves the complete removal of the tumorous growth. The characteristics of the tumors are described in more detail below.