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1

Begum, Shirin Akter, Md Zillur Rahman Bhuiyan, Rehana Akhter, Romena Afroz, Afroza Khanom, and Kashfia Ahmed Keya. "A review on gestational trophoblastic disease." Bangladesh Medical Journal 44, no. 1 (January 12, 2016): 51–56. http://dx.doi.org/10.3329/bmj.v44i1.26357.

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Molar pregnancy occurs when the fertilization of the egg by the sperm goes wrong and leads to the growth of abnormal cells or clusters of water filled sacs inside the womb. This condition is one of a group of conditions known as gestational trophoblastic tumours (GTTs). Molar pregnancies used to be called hydatidiform mole but now most people call them molar pregnancies. Molar pregnancies are rare but they are the most common type of gestational trophoblastic tumour. In the UK, about 1 in 590 pregnancies is a molar pregnancy. In Asian women, molar pregnancies are about twice as common as in Caucasian women. Most molar pregnancies are benign. They can spread beyond the womb in some women, but are still curable. Molar pregnancies can either be complete or partial. In case of complete mole, no parts of foetal tissue are formed. In case of partial mole there may be some foetal tissue in the womb, alongside the molar tissue. By measuring the levels of ?hCG in blood and urine in high dilution helps to diagnose a molar pregnancy; an ultrasound scan can also diagnose many women with molar pregnancy. The molar tissue needs to be surgically removed. Afterwards, in around 10 to 15 out of 100 women, some molar tissue remains in the deeper tissues of the womb or other parts of the body. This is called a persistent gestational tumour. Invasive mole, choriocarcinoma, and placental site trophoblastic tumor (PSTT) termed as “gestational trophoblastic neoplasia” (GTN), which can progress, invade, metastasize, and lead to death if left untreated.These women need to have chemotherapy completely get rid of the abnormal cells.Bangladesh Med J. 2015 Jan; 44 (1): 51-56
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2

Lehman, E., D. M. Gershenson, T. W. Burke, C. Levenback, E. G. Silva, and M. Morris. "Salvage surgery for chemorefractory gestational trophoblastic disease." Journal of Clinical Oncology 12, no. 12 (December 1994): 2737–42. http://dx.doi.org/10.1200/jco.1994.12.12.2737.

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PURPOSE To investigate and define better the role of salvage surgery for patients with chemorefractory gestational trophoblastic disease (GTD). PATIENTS AND METHODS A retrospective review of medical records at The University of Texas M.D. Anderson Cancer Center identified 33 patients with chemorefractory GTD who underwent salvage surgery between 1962 and 1991. The end points selected for analysis were serologic response and survival. RESULTS Initial salvage procedures consisted of 29 hysterectomies, four thoracotomies, and one nephrectomy (in conjunction with a hysterectomy). Fourteen patients (42%) had a serologic complete response (CR) to surgery (normalization of human chorionic gonadotropin [hCG]), 10 (30%) had a partial response (> 50% decrease in hCG level), and nine had no response (< or = 50% decrease in hCG level). Of 19 patients who received further chemotherapy, eight (42%) attained a CR. Four patients underwent a second salvage surgery: two thoracotomies, one craniotomy, and one partial hepatectomy. All achieved a CR. The probability of achieving a CR was influenced by the time from diagnosis to surgery, number of preoperative disease sites, preoperative World Health Organization (WHO) score, and histologic type. Survival was influenced by the type of antecedent pregnancy, number of preoperative regimens, number of preoperative disease sites, time from diagnosis to surgery, and preoperative WHO score. CONCLUSION Based on the findings of this study, it appears that a select subset of patients with chemorefractory GTD who have a limited number of clinically detectable tumor foci may benefit from salvage surgery.
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3

Kubelka-Sabit, KB, I. Prodanova, D. Jasar, G. Bozinovski, V. Filipovski, S. Drakulevski, and D. Plaseska-Karanfilska. "Molecular and immunohistochemical characteristics of complete hydatidiform moles." Balkan Journal of Medical Genetics 20, no. 1 (June 30, 2017): 27–34. http://dx.doi.org/10.1515/bjmg-2017-0009.

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AbstractMolar pregnancy is a gestational trophoblastic disease that belongs to the category of precancerous lesions. On the other end of the spectrum are gestational trophoblastic neoplasms such as invasive mole, choriocarcinoma, placental site trophoblastic tumor and epithelioid trophoblastic tumor, which are considered malignant tumors. Based on defined histopathological criteria, molar pregnancy is divided into partial and complete hydatidiform mole. Especially in the case of early complete mole, the diagnosis can be quite challenging and often necessitates additional molecular or immunohistochemical methods. The aim of this study was to assess the importance of additional molecular and immunohistochemical methods to accurately diagnose complete hydatidiform mole and to stress the importance of correct diagnosis and close follow-up of these patients. A total of 367 consecutive cases of spontaneous abortion were analyzed in a 3-year period. Eight cases with histopathological diagnosis of complete molar pregnancy were selected for further analysis. Apart from standard microscopic analysis, additional molecular and immunohistochemical analyses were performed in all eight cases. Most of the histopathological characteristics of complete molar pregnancy were present in all cases, together with complete absence of positivity for the p57 immunohistochemical marker in the cytotrophoblasts and villous stromal cells. The molecular analysis revealed androgenetic diploidy in seven cases and biparental diploidy in one case with more than three consecutive complete molar pregnancies. Additional immunohistochemical and molecular methods can considerably aid in the correct diagnosis of molar pregnancy.
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4

Deep, JP, LB Sedhai, J. Napit, and J. Pariyar. "Gestational Trophoblastic Disease." Journal of Chitwan Medical College 3, no. 2 (August 13, 2013): 4–11. http://dx.doi.org/10.3126/jcmc.v3i2.8434.

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Gestational trophoblastic disease (GTD) is a group of tumors that arise from placental tissue and secrete β-hCG. GTD is a combination of benign or invasive mole and malignant known as Gestational Trophoblastic Neoplasia (GTN). Prevalence, diagnosis and treatment of GTD have drastically changed in recent years. DOI: http://dx.doi.org/10.3126/jcmc.v3i2.8434 Journal of Chitwan Medical College Vol.3(2) 2013 4-11
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5

Bolck, F. "Gestational Trophoblastic Disease." Experimental pathology 35, no. 1 (January 1988): 56. http://dx.doi.org/10.1016/s0232-1513(88)80123-3.

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6

Bannatyne, Patricia M. "Gestational Trophoblastic Disease." Pathology 20, no. 4 (1988): 401. http://dx.doi.org/10.1016/s0031-3025(16)36572-2.

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7

Zivaljevic, Milica, Marija Tesic, Tamara Vujkov, Jelka Rajovic, and Marina Popovic. "Gestational trophoblastic disease." Archive of Oncology 10, no. 2 (2002): 71–75. http://dx.doi.org/10.2298/aoo0202071z.

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Gestational trophoblastic disease belongs to a spectrum of rare tumors originating from trophoblast. It spreads from the benignant disease uncomplicated partial mole to the most malignant choriocarcinoma in stage IV of disease with brain metastases. Fortunately, with adequate chemotherapy even patients in advanced stage of the disease have significant chances to be cured. In estimating prognosis and adequate therapy of disease, the most significant are clinical factors: serum hCG level, duration of the disease from termination of antecedent pregnancy, prior chemotherapy, brain or liver metastases. hCG is an ideal tumor marker for follow up and early diagnosis of recidivism and metastases. In the Institute of Oncology in Sremska Kamenica 32 patients with gestational trophoblastic disease were treated in the period from 1987 to 2001. All the patients with non-metastatic disease and low risk metastatic disease (stage I-III FIGO) were successfully cured. Five patients died, all in stage IV of the disease (FIGO) with liver and brain metastases; in 4 of them disease occurred after term pregnancy. Overall survival was 85%. Treatment of non-metastatic and low risk metastatic disease was successful in all cases. Treatment failures occurred in advanced disease with brain and liver metastasis Specificity and low incidence of this disease ask for the treatment to be carried out in specialized centers, as it is in developed countries (Trophoblastic Disease Centers).
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8

Shapter, Anne P., and Robert McLellan. "GESTATIONAL TROPHOBLASTIC DISEASE." Obstetrics and Gynecology Clinics of North America 28, no. 4 (December 2001): 805–17. http://dx.doi.org/10.1016/s0889-8545(05)70237-0.

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9

Tse, Ka Yu, Karen K. L. Chan, Kar Fai Tam, and Hextan Y. S. Ngan. "Gestational trophoblastic disease." Obstetrics, Gynaecology & Reproductive Medicine 19, no. 4 (April 2009): 89–97. http://dx.doi.org/10.1016/j.ogrm.2008.12.002.

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10

Shanbhogue, Alampady K. P., Neeraj Lalwani, and Christine O. Menias. "Gestational Trophoblastic Disease." Radiologic Clinics of North America 51, no. 6 (November 2013): 1023–34. http://dx.doi.org/10.1016/j.rcl.2013.07.011.

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11

Ngan, H. Y. S. "Gestational trophoblastic disease." Reviews in Gynaecological Practice 3, no. 3 (September 2003): 142–47. http://dx.doi.org/10.1016/s1471-7697(03)00047-9.

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12

Seckl, Michael J., Neil J. Sebire, and Ross S. Berkowitz. "Gestational trophoblastic disease." Lancet 376, no. 9742 (August 2010): 717–29. http://dx.doi.org/10.1016/s0140-6736(10)60280-2.

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13

Chestnut, D. H. "Gestational trophoblastic disease." Yearbook of Anesthesiology and Pain Management 2011 (January 2011): 311. http://dx.doi.org/10.1016/j.yane.2010.10.004.

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14

Elston, C. "Gestational Trophoblastic Disease." Journal of Clinical Pathology 41, no. 2 (February 1, 1988): 239. http://dx.doi.org/10.1136/jcp.41.2.239-a.

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15

Schoolmeester, J. Kenneth, and Lori A. Erickson. "Gestational Trophoblastic Disease." Mayo Clinic Proceedings 92, no. 11 (November 2017): 1739–40. http://dx.doi.org/10.1016/j.mayocp.2017.09.005.

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16

Livolsi, Virginia A. "Gestational Trophoblastic Disease." American Journal of Clinical Pathology 93, no. 1 (January 1, 1990): 159. http://dx.doi.org/10.1093/ajcp/93.1.159a.

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17

Ngan, Hextan Y. S. "Gestational trophoblastic disease." Current Obstetrics & Gynaecology 13, no. 2 (April 2003): 95–101. http://dx.doi.org/10.1054/cuog.2002.0316.

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18

Stone, Michael B., and Nancy E. Conroy. "Gestational Trophoblastic Disease." Academic Emergency Medicine 17, no. 1 (January 2010): E6. http://dx.doi.org/10.1111/j.1553-2712.2009.00613.x.

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19

GARNER, ELIZABETH I. O., DONALD P. GOLDSTEIN, COLLEEN M. FELTMATE, and ROSS S. BERKOWITZ. "Gestational Trophoblastic Disease." Clinical Obstetrics and Gynecology 50, no. 1 (March 2007): 112–22. http://dx.doi.org/10.1097/grf.0b013e31802f17fc.

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20

Berkowitz, Ross S., and Donald P. Goldstein. "Gestational trophoblastic disease." Cancer 76, S10 (November 15, 1995): 2079–85. http://dx.doi.org/10.1002/1097-0142(19951115)76:10+<2079::aid-cncr2820761329>3.0.co;2-o.

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21

Jain, Kiran A. "Gestational Trophoblastic Disease." Ultrasound Quarterly 21, no. 4 (December 2005): 245–53. http://dx.doi.org/10.1097/01.ruq.0000191658.95192.89.

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22

Endo, Yoshimi. "Gestational Trophoblastic Disease." Ultrasound Quarterly 28, no. 2 (June 2012): 128. http://dx.doi.org/10.1097/01.ruq.0000415530.37527.ae.

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23

Fox, H. "Gestational trophoblastic disease." BMJ 314, no. 7091 (May 10, 1997): 1363. http://dx.doi.org/10.1136/bmj.314.7091.1363.

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24

Soper, John T. "Gestational Trophoblastic Disease." Obstetrics & Gynecology 108, no. 1 (July 2006): 176–87. http://dx.doi.org/10.1097/01.aog.0000224697.31138.a1.

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25

Schorge, John O., Donald P. Goldstein, Marilyn R. Bernstein, and Ross S. Berkowitz. "Gestational Trophoblastic Disease." Current Treatment Options in Oncology 1, no. 2 (April 2000): 169–75. http://dx.doi.org/10.1007/s11864-000-0062-5.

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26

Tse, K. Y., and Hextan Y. S. Ngan. "Gestational trophoblastic disease." Best Practice & Research Clinical Obstetrics & Gynaecology 26, no. 3 (June 2012): 357–70. http://dx.doi.org/10.1016/j.bpobgyn.2011.11.009.

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27

Ngan, Hextan Y. S., Karen K. L. Chan, and Kar-Fai Tam. "Gestational trophoblastic disease." Current Obstetrics & Gynaecology 16, no. 2 (April 2006): 93–99. http://dx.doi.org/10.1016/j.curobgyn.2006.01.005.

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28

Wells, Michael. "Gestational trophoblastic disease." Placenta 9, no. 4 (July 1988): 457–58. http://dx.doi.org/10.1016/0143-4004(88)90059-8.

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29

Soper, John T. "Gestational Trophoblastic Disease." Obstetrics & Gynecology 137, no. 2 (January 5, 2021): 355–70. http://dx.doi.org/10.1097/aog.0000000000004240.

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30

Lolar, Sara. "Gestational trophoblastic disease." Journal of the American Academy of Physician Assistants 34, no. 4 (April 2021): 52–53. http://dx.doi.org/10.1097/01.jaa.0000735796.40503.de.

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31

Jelly, Prasuna, and Rakesh Sharma. "Gestational trophoblastic disease (GTD)." International Journal of Medical Paediatrics and Oncology 2, no. 2 (2016): 70. http://dx.doi.org/10.5958/2455-6793.2016.00008.0.

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32

Elhossamy, Hashem, and Hassan Morsi. "Ectopic Gestational Trophoblastic Disease." Journal of Gynecologic Surgery 30, no. 6 (December 2014): 360–62. http://dx.doi.org/10.1089/gyn.2014.0054.

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33

Fallahian, M. "Familial Gestational Trophoblastic Disease." Placenta 24, no. 7 (August 2003): 797–99. http://dx.doi.org/10.1016/s0143-4004(03)00105-x.

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34

Rodriguez, Noah, Donald P. Goldstein, and Ross S. Berkowitz. "Treating gestational trophoblastic disease." Expert Opinion on Pharmacotherapy 11, no. 18 (October 19, 2010): 3027–39. http://dx.doi.org/10.1517/14656566.2010.512288.

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35

Alhamdan, Dalya, Tommaso Bignardi, and George Condous. "Recognising gestational trophoblastic disease." Best Practice & Research Clinical Obstetrics & Gynaecology 23, no. 4 (August 2009): 565–73. http://dx.doi.org/10.1016/j.bpobgyn.2009.03.001.

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36

Soper, John T., and Charles B. Hammond. "Nonmetastatic Gestational Trophoblastic Disease." Obstetrics and Gynecology Clinics of North America 15, no. 3 (September 1988): 505–19. http://dx.doi.org/10.1016/s0889-8545(21)00123-6.

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37

Milenkovic, Vera, and Biljana Lazovic. "Gestational trophoblastic disease: Literature review." Medical review 64, no. 3-4 (2011): 188–93. http://dx.doi.org/10.2298/mpns1104188m.

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Gestational trophoblastic disease is characterized by abnormal proliferation of pregnancy-associated trophoblastic tissue with malignant potential. Gestational trophoblastic disease covers a spectrum of conditions including hydatidiform mole, invasive mole, choriocarcinoma and placental site trophoblastic tumour. It is very important to understand the pathophysiology and natural history of the disease in order to achieve faster recognition and effective treatment. The presence and course of the disease can be monitored with quantitative levels of human chorionic gonadotrophin in all cases. Clinical signs and symptoms are usually insufficient to diagnose and predict the extent of disease. Nowadays, gestational trophoblastic diseases are the best treated gynaecological malignancy thanks to modern technology. This review covers various aspects of gestational trophoblastic disease: its development, epidemiology, aetiology and pathogenesis, as well as its classification, clinical manifestations and diagnostic methods.
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38

Castillo, I., J. Lopez, J. E. Leiva, C. Paredes, and R. Correa. "MOLECULAR CHARACTERIZATION OF GESTATIONAL TROPHOBLASTIC DISEASE: IGCS-0097 Gestational Trophoblastic Neoplasia." International Journal of Gynecologic Cancer 25, Supp 1 (May 2015): 43. http://dx.doi.org/10.1136/00009577-201505001-00033.

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39

Lurain, John R. "Gestational trophoblastic disease II: classification and management of gestational trophoblastic neoplasia." American Journal of Obstetrics and Gynecology 204, no. 1 (January 2011): 11–18. http://dx.doi.org/10.1016/j.ajog.2010.06.072.

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40

Kenny, Laura, and Michael J. Seckl. "Treatments for gestational trophoblastic disease." Expert Review of Obstetrics & Gynecology 5, no. 2 (March 2010): 215–25. http://dx.doi.org/10.1586/eog.10.13.

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41

Abdellatif, Mahmoud, sabry mahmoud, Ibrahim Hassanein, and Mohamed Salem. "Gestational trophoblastic disease updated management." Sohag Medical Journal 23, no. 2 (April 1, 2019): 147–54. http://dx.doi.org/10.21608/smj.2019.47656.

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42

Bayatpour, Mahin, and Juan Reyes. "Gestational trophoblastic disease among adolescents." Adolescent and Pediatric Gynecology 6, no. 4 (1993): 220–22. http://dx.doi.org/10.1016/s0932-8610(12)80047-8.

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43

Smith, Harriet O., Ernest Kohorn, and Laurence A. Cole. "Choriocarcinoma and Gestational Trophoblastic Disease." Obstetrics and Gynecology Clinics of North America 32, no. 4 (December 2005): 661–84. http://dx.doi.org/10.1016/j.ogc.2005.08.001.

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44

Lin, Lawrence Hsu, Rodrigo Polizio, Koji Fushida, and Rossana Pulcineli Vieira Francisco. "Imaging in Gestational Trophoblastic Disease." Seminars in Ultrasound, CT and MRI 40, no. 4 (August 2019): 332–49. http://dx.doi.org/10.1053/j.sult.2019.03.002.

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45

Huang, S. C. "Gestational trophoblastic disease in Taiwan." Placenta 19, no. 7 (September 1998): A6. http://dx.doi.org/10.1016/s0143-4004(98)91064-5.

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46

Lurain, John R. "Pharmacotherapy of gestational trophoblastic disease." Expert Opinion on Pharmacotherapy 4, no. 11 (November 2003): 2005–17. http://dx.doi.org/10.1517/14656566.4.11.2005.

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47

Braga, Antonio, Lawrence Lin, Izildinha Maestá, Sue Sun, Elza Uberti, José Madi, and Maurício Viggiano. "Gestational Trophoblastic Disease in Brazil." Revista Brasileira de Ginecologia e Obstetrícia / RBGO Gynecology and Obstetrics 41, no. 04 (April 2019): 211–12. http://dx.doi.org/10.1055/s-0039-1688566.

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48

BENTLEY, REX C. "Pathology of Gestational Trophoblastic Disease." Clinical Obstetrics and Gynecology 46, no. 3 (September 2003): 513–22. http://dx.doi.org/10.1097/00003081-200309000-00004.

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49

Monchek, Ruth, and Susan Wiedaseck. "Gestational Trophoblastic Disease: An Overview." Journal of Midwifery & Women's Health 57, no. 3 (May 2012): 255–59. http://dx.doi.org/10.1111/j.1542-2011.2012.00177.x.

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50

M. Chaied, Hassna, and Zaineb .T. AL Yasin. "GESTATIONAL TROPHOBLASTIC DISEASE IN BASRAH." Medical Journal of Basrah University 25, no. 2 (December 28, 2007): 52–56. http://dx.doi.org/10.33762/mjbu.2007.48267.

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