AVANÇOS NO DIAGNÓSTICO PRECOCE E NO MANEJO MULTIPROFISSIONAL DAS NEOPLASIAS TROFOBLÁSTICAS GESTACIONAIS: UM DESAFIO PARA A OBSTETRÍCA MODERNA

Abstract

Gestational trophoblastic neoplasms (GTNs) represent a spectrum of diseases arising from trophoblastic tissue, ranging from hydatidiform mole to malignant forms such as choriocarcinoma. Although rare, they carry high morbidity and mortality when not diagnosed early. With advances in diagnostic techniques, such as serial measurement of human chorionic gonadotropin (β-hCG) and the use of high-resolution ultrasound, a significant transformation has occurred in the prognosis of these patients. In this context, understanding the advances in early diagnosis and in multiprofessional management has become essential for modern obstetrics, which faces the challenge of ensuring comprehensive and effective maternal care. The aim of this study was to analyze the progress achieved in early diagnosis and in multiprofessional management of GTNs, highlighting their relevance to current clinical practice. To this end, a narrative literature review was conducted, based on scientific articles available in the PubMed, SciELO, and LILACS databases, published between 2020 and 2025, using the descriptors “gestational trophoblastic neoplasia,” “early diagnosis,” “multiprofessional management,” and “obstetrics.” Original studies, systematic reviews, and recent clinical guidelines were included. The analysis results demonstrated that early diagnosis, combined with β-hCG monitoring and risk stratification, reduces complications and guides individualized approaches. Standardized protocols from organizations such as FIGO and WHO have established safe criteria for treatment selection, ranging from single-agent chemotherapy to multi-agent regimens for more severe cases. Furthermore, multiprofessional management has proven to be decisive not only for therapeutic success but also for the emotional and social follow-up of patients, with the integrated participation of obstetricians, oncologists, pathologists, psychologists, and nursing teams. Recent studies also highlight that rehabilitation and psychosocial support contribute to better treatment adherence and improved quality of life after clinical outcomes. It is concluded that advances in early diagnosis and multiprofessional management have revolutionized obstetric practice in the field of GTNs, raising cure rates to over 90% in specialized centers. However, challenges remain, especially regarding inequality in access to diagnostic and therapeutic resources in developing countries. Therefore, it is necessary to expand professional training, consolidate integrated protocols, and strengthen public policies that ensure universal and equitable access to treatment, thus guaranteeing the continuity of progress achieved in this area.