Western Australian Trophoblastic Centre
Overview / Role of Service / Clinic
The Western Australian Trophoblastic Centre (WATC) is a specialist multidisciplinary service that provides holistic care in partnership with the patient’s General Practitioner, for those affected by Gestational Trophoblastic Disease. The WATC is based at Women and Newborn Health Service’s King Edward Memorial Hospital, and provides care to those affected across Western Australia, via in person and telehealth consultations.
The WATC provides centralised and specialised care to our patients with trophoblastic diseases. This includes all patients with partial mole, complete mole, choriocarcinoma, atypical placental site nodule, placental site trophoblastic disease and epithelioid trophoblastic disease, regardless of the planned follow-up / treatment.
The service has several components as follows:
- A bespoke trophoblastic diseases patient registry
- A multidisciplinary clinic involving medical, gynaecology, nursing, oncology and psychology staff
- A trophoblastic diseases Multi-Disciplinary Team
- A specific clinic for the administration of low risk chemotherapy (methotrexate).
Clinical inclusion
- Any partial or complete molar pregnancy not receiving chemotherapy but having follow up βhCGs, regardless of where in their surveillance they are and regardless of whether their βhCG has already normalised
- Any new diagnosis of trophoblastic disease (partial mole, complete mole, choriocarcinoma, atypical placental site nodule, placental site trophoblastic disease, epithelioid trophoblastic disease).
OR
High index of suspicion of Gestational Trophoblastic Disease (GTD) as:
- Persistent high levels of βhCG following cessation of a pregnancy
- βhCG elevation following a molar pregnancy
- Abnormal vaginal bleeding with raised βhCG, abdominal pain or swelling and ultrasound excludes pregnancy
- Transvaginal ultrasound suggestive of GTD.
Clinical exclusion
Other gynaecological cancers are to be referred to the Western Australia Gynaecologic Cancer Service.
Frequency of clinic
A weekly multidisciplinary clinic, with allied health appointments available on other days throughout the week.
Referral to include
- Copies of prerequisite investigations:
Pre-Requisite investigations
- BHCG
- FBC, TFTs
- CXR
- Pelvic USS
- Copy of the histopathology
- Further imaging to be determined by the consultant
- Please indicate if these results are also uploaded to patient’s MyHealthRecord.
- Details of preceding pregnancy including type of pregnancy, method of management of pregnancy loss, βhCG levels at the time of diagnosis of GTD
- Detailed clinical information about the patient, including past medical, surgical, obstetric and gynaecological history
- Details of clinical concerns of referring doctor and or patient.
Urgent referral
For those requiring urgent review within 7 days, please contact the On Call Gynaecologic Oncology Fellow via KEMH switchboard (08) 6458 2222 or the on call Gynaecologic Oncology Consultant.
Referral process
All referrals are sent via the Central Referral Service WA (CRS) (external site), unless urgent and discussed with Fellow or Consultant. Ensure you provide the relevant information in the referral to enable appropriate triage, including required investigation results and letters from treating medical practitioners if relevant and clearly requesting the Western Australian Trophoblastic Centre.
Referrals using GP software that include all the relevant history and information are also welcome using CRS referral form templates (external site).
Contact information
For clinical advice regarding Gestational Trophoblastic Disease, GPs are always welcome and encouraged to phone KEMH and ask to speak to the Gynaecologic Oncology Fellow or the on-call Gynaecologic Oncology Consultant via phone number (08) 6458 2222.
Useful links
Consumer resources
Cancer Australia: Gestational trophoblastic disease (external site)
RCOG: Molar pregnancy and gestational trophoblastic disease (external site)
Health professional resources