Int J Gynecol Obstet 143: 79 - 85, 2018. doi: 10.1002 / ijgo.12615 Key Points Suspect gestational trophoblastic disease during early pregnancy if uterine size is much larger than expected for dates, if beta-hCG levels are unexpectedly high during, if there are symptoms or signs of preeclampsia, or if ultrasonographic findings suggest gestational trophoblastic disease.