Gestational trophoblastic disease

​​​​​​​​Emergency

If any of the following are suspected, seek emergency medical advice or refer the patient to the emergency department (via ambulance if necessary)

  • Chronic or acute blood loss with elevated beta human chorionic gonadotropin (ßhCG)
  • Detection of cerebral, pulmonary or liver metastases in combination with elevated ßhCG
  • Hyperthyroidism crisis with elevated ßhCG
  • Respiratory distress or pulmonary embolism with elevated ßhCG
  • Significant or uncontrolled vaginal bleeding 6 weeks post-partum in the presence of a positive ßhCG

When public outpatient services are not routinely provided

  • ​Nil​

Criteria to access public outpatient services

CategoryCriteria
Category 1
Recommended to be seen within 30 calendar days.

  • Diagnosis of any of the following features:
    • Gestational choriocarcinoma
    • Gestational trophoblastic neoplasia (GTN)
    • Invasive mole
    • Epithelioid trophoblast tumour (ETT)
    • Placental site trophoblastic tumour (PSTT)
​​​​Note: for optimum care, patient should be reviewed within 1 week
  • Following monitoring of a molar pregnancy with weekly ßhCG assessment showing plateauing or rising levels
  • Following diagnosis of molar pregnancy with ßhCG assessment showing declining yet persisting levels after 6 months of monitoring ​

​Category 2
Recommended to be seen within 90 calendar days.
  • ​​​History of molar pregnancies​

Category 3
Recommended to be seen within 365 calendar days.

  • Nil

Information to include within a referral

Required

  • Reason for referral
  • Details of the presenting condition, including symptoms and their duration
  • Details of preceding pregnancy, including date of last pregnancy, type of pregnancy and method of management of pregnancy loss
  • Patient health summary (such as relevant medical history, relevant investigations, current medications and dosages, allergies and/or adverse reactions), including specifically:
    • Past medical, surgical, obstetric and psychosocial history
    • Family history (where relevant)
    • Pre-menopausal or post-menopausal
    • Hormonal contraception use
    • Height, weight and body mass index
    • Pelvic examination findings
    • Full blood count (FBC)
    • Urea, Electrolytes, Creatinine (UEC)
    • Liver function tests (LFTs)
    • Blood glucose levels (BGLs)
    • Thyroid function test results
    • Beta human chorionic gonadotropin (ßhCG), including levels at the time of diagnosis
    • Most recent cervical screening test or co-test
    • Diagnostic pathology reports, including pathology provider, accession number and a copy of the histopathology
    • Diagnostic imaging reports, including imaging provider and accession number, particularly chest x-ray and pelvic ultrasound

If available

  • ​​Nil

Important information for referring health professionals

If there is a change to a patient’s condition while waiting for their appointment, referring health professionals may further investigate and manage the situation, or send an updated referral to the outpatient service. Where there are significant concerns about a patient's condition, referring health professionals may check HealthPathways for urgent/same day advice or contact the relevant clinical team.​

Additional adult gynaecological oncology services

Current as at: Monday 23 March 2026
Contact page owner: System Purchasing