The symptoms of GTN can vary depending on the type and extent of the disease. Common symptoms include abnormal vaginal bleeding, an unusually large uterus for gestational age, severe nausea and vomiting, and high levels of human chorionic gonadotropin (hCG) in the blood. In more advanced cases, symptoms may include pelvic pain, pressure, or signs of metastasis, such as coughing or hemoptysis if the lungs are involved.