Diagnosis of Gestational Trophoblastic Disease Serum beta subunit of human chorionic gonadotropin (beta-hCG) Pelvic ultrasonography Pathology evaluation of evacuated uterine contents or endometrial biopsy Gestational trophoblastic disease is suspected in women with a positive pregnancy test and any of the following: Unexpectedly high levels of beta-hCG detected during pregnancy testing (except for placental site trophoblastic tumor and epithelioid trophoblastic tumor, which result in low beta-hCG levels) Uterine size much larger than expected for dates Symptoms or signs of preeclampsia in 1st or 2nd trimester Vaginal passage of grapelike tissue Suggestive findings (eg, mass containing multiple cysts, absence of a fetus and amniotic fluid) seen during ultrasonography done to evaluate pregnancy Unexplained metastases in women of child-bearing age with an unknown primary tumor Postmolar gestational trophoblastic neoplasia is most frequently diagnosed based on hCG levels and should be excluded if abnormal uterine bleeding occurs after any pregnancy.