Which are the causes of Gestational trophoblastic disease?

Causes of Gestational Trophoblastic Disease

Gestational trophoblastic disease (GTD) is a group of rare conditions that occur during pregnancy, involving abnormal growth of cells inside the uterus. It is important to understand the causes of GTD to better diagnose and manage this condition. While the exact cause of GTD is not always clear, several factors have been identified that may contribute to its development.

1. Abnormal Fertilization

GTD often occurs due to abnormal fertilization of an egg. In a normal pregnancy, a sperm fertilizes an egg, resulting in the formation of a healthy embryo. However, in GTD, the fertilization process goes awry, leading to the formation of abnormal cells instead of a normal embryo. This abnormal fertilization can occur in various ways, such as:

• Complete Hydatidiform Mole: This occurs when a sperm fertilizes an empty egg, resulting in the absence of fetal tissue and the growth of abnormal placental tissue.


• Partial Hydatidiform Mole: In this case, two sperm fertilize a normal egg, leading to an abnormal embryo with extra sets of chromosomes.


• Choriocarcinoma: This is a rare form of cancer that can develop from GTD. It arises when the abnormal placental tissue continues to grow and invade other parts of the body.

2. Maternal Age

Advanced maternal age has been identified as a risk factor for GTD. Women who become pregnant at an older age, typically over 35, have a higher chance of developing GTD compared to younger women. The exact reason behind this association is not fully understood, but it may be related to changes in the reproductive system that occur with age.

3. Previous GTD

Having a history of GTD increases the risk of developing the condition again in future pregnancies. Women who have previously experienced a molar pregnancy or other forms of GTD have a higher likelihood of recurrence. Regular follow-up and monitoring are crucial for early detection and appropriate management in subsequent pregnancies.

4. Ethnicity

Certain ethnic groups have a higher incidence of GTD compared to others. For example, women of Southeast Asian descent, particularly those from the Philippines and Indonesia, have an increased risk. The reasons for these ethnic disparities are not well understood and may involve genetic, environmental, or lifestyle factors.

5. Nutritional Factors

Poor nutrition and certain dietary deficiencies have been suggested as potential risk factors for GTD. Insufficient intake of certain vitamins and minerals, such as folic acid, may contribute to the development of abnormal placental growth. However, more research is needed to establish a direct link between nutrition and GTD.

6. Hormonal Imbalances

Imbalances in hormone levels during pregnancy can play a role in the development of GTD. Specifically, high levels of human chorionic gonadotropin (hCG), a hormone produced by the placenta, have been associated with an increased risk of GTD. However, it is important to note that hormonal imbalances alone are not sufficient to cause GTD, and other factors are usually involved.

7. Genetic Factors

Genetic abnormalities have been implicated in the development of GTD. Certain gene mutations or alterations may predispose individuals to abnormal placental growth. However, the specific genes involved and their mechanisms of action are still being investigated.

8. Environmental Factors

Exposure to certain environmental factors may increase the risk of GTD. For instance, exposure to high levels of radiation or certain chemicals has been suggested as potential risk factors. However, more research is needed to establish a definitive link between environmental factors and GTD.

In conclusion, while the exact causes of gestational trophoblastic disease are not fully understood, several factors have been identified that may contribute to its development. Abnormal fertilization, advanced maternal age, previous GTD, ethnicity, nutritional factors, hormonal imbalances, genetic factors, and environmental factors are all potential contributors. Further research is needed to gain a deeper understanding of these causes and develop effective prevention and treatment strategies.