Gestational trophoblastic disease.

Gestational trophoblastic disease is an aberration of pregnancy that occurs in one of 1,500 pregnancies in the United States. Abnormalities of uterine size, vaginal bleeding, and first trimester toxemia are common presentations. After a D & C, follow-up consists of close monitoring of the serum beta-hCG and adherence to contraception. Approximately 15% of patients have malignant disease requiring chemotherapy. Prognosis has changed from fatal to highly curable with preservation of the uterus for future childbearing. Nurses provide education and support to the patient and family as they deal with pregnancy loss and the threat of cancer.