A case of Gestational Trophoblastic Neoplasia belongs to high risk group if disease develops after:
1.Hydatidiform mole
2.Full term preganancy
3.Spontaneous abortion
4.Ectopic preganancy
exp:
High risk gestational trophoblastic disease.
FIGO in 2000 devised a staging system for categorisation of gestational trophoblastic neoplasia into good prognostic (low risk) and bad prognostic (high risk) disease.
Good prognosis (Low risk)
Short duration (< 4 months)
Serum β-hCG < 40,000 mIU/ml
Metastasis limited to lung and vagina
No significant prior chemotherapy
No preceding term pregnancy
Bad prognosis (Low risk)
Long duration (> 4 months)
Serum 6-hCG > 40,000 mIU/ml
Metastasis to brain or liver
Unsuccessful prior chemotherapy
Gestational trophoblastic neoplasia following term pregnancy.
Also if we have a look at the WHO prognostic scoring system: GTN following a term pregnancy comes under high risk.
Remember:
High risk GIN occurs after term pregnancy .
GTN occurs most commonly after H mole.