Gestational trophoblastic disease: our patients deserve better case detection and follow up.

The World Health Organisation’s (WHO) classification of gestational trophoblastic disease includes complete, partial, invasive and metastatic hydatidiform mole, exaggerated placental site nodule or plaque and two malignant tumoursplacental site trophoblastic tumour and choriocarcinoma [1]. The incidence of gestational trophoblastic disease (GTD) in Sri Lanka according to a hospital based study is 1 in 213 pregnancies [2] as compared to 1 in 2000 pregnancies in the USA [3]. Complete moles (CMs) are more common in Asian women [4]. The incidence of partial moles (PMs) is similar to that of CMs. PMs tend to be less often recognised clinically or pathologically, since their appearances are more subtle and easily misinterpreted as a spontaneous abortion by clinicians or as ‘products of conception’ by pathologists. Ideally, all tissue from a spontaneous abortion in the first trimester should be sent for histological examination for evidence of GTD.