Beta-human chorionic gonadotropin levels as early predictor for progression to Gestational Trophoblastic Neoplasia after molar pregnancy evacuation at a Philippine tertiary hospital

β-human chorionic gonadotropin (HCG) level is not a reliable marker for early identification of persistent gestational trophoblastic neoplasia (GTN) after evacuation of hydatidiform mole. Thus, this study was conducted to evaluate β-HCG regression after evacuation as a predictive factor of malignant GTN in complete molar pregnancy. Methods. In this cross-sectional study, we evaluated a total of 260 patients with complete molar pregnancy. Sixteen of the 260 patients were excluded. Serum levels of HCG were measured in all patients before treatment and after evacuation. HCG level was measured weekly until it reached a level lower than 5 mIU/mL. Results. The only predictors of persistent GTN are HCG levels one and two weeks after evacuation. The cut-off point for the preevacuation HCG level was 6000 mIU/mL (area under the curve, AUC, 0.58; sensitivity, 38.53%; specificity, 77.4%), whereas cut-off points for HCG levels one and two weeks after evacuation were 6288 mIU/mL (AUC, 0.63; sensitivity, 50.46%; specificity, 77.0%) and 801 mIU/mL (AUC, 0.80; sensitivity, 79.82%; specificity, 71.64%), respectively. Conclusion. The rate of decrease of HCG level at two weeks after surgical evacuation is the most reliable and strongest predictive factor for the progression of molar pregnancies to persistent GTN.

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Intramural ectopic pregnancy

Archive of oncology ◽

10.2298/aoo1002030l ◽

2010 ◽

Vol 18 (1-2) ◽

pp. 30-31

Author(s):

Biljana Lazovic ◽

Vera Milenkovic

Keyword(s):

Ectopic Pregnancy ◽

Chorionic Gonadotropin ◽

Human Chorionic Gonadotropin ◽

Elevated Serum ◽

Normal Pregnancy ◽

Primiparous Woman ◽

Histopathological Analysis ◽

Molar Pregnancy ◽

Gestational Trophoblastic Neoplasia ◽

History Of

Gestational trophoblastic neoplasia refers to a subset of gestational trophoblastic conditions characterized with persistently elevated serum ?-human chorionic gonadotropin, absence of a normal pregnancy, and a history of normal or abnormal pregnancies. We described a case of suspected ectopic molar pregnancy in a primiparous woman who had elevated ?-human chorionic gonadotropin and required chemotherapy to achieve remission. Final histopathological finding was ectopic pregnancy; no gestational trophoblastic neoplasia was found. This case stresses the importance of histopathological analysis in diagnosis of gestational trophoblastic neoplasia when ectopic pregnancy is present, considering that histopathological analysis is less sensitive for gestational trophoblastic neoplasia than for ectopic pregnancy.

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Recurrent Molar Pregnancy: An Obstetric Dilemma?

International Journal of Infertility & Fetal Medicine ◽

10.5005/jp-journals-10016-1043 ◽

2012 ◽

Vol 3 (2) ◽

pp. 63-64 ◽

Cited By ~ 1

Author(s):

Lakshmi Rathna Marakani ◽

Sirisha Rao Gundabattula

Keyword(s):

Chorionic Gonadotropin ◽

Human Chorionic Gonadotropin ◽

Nulliparous Woman ◽

Molar Pregnancy ◽

Persistent Disease ◽

Beta Human Chorionic Gonadotropin ◽

Β Hcg

ABSTRACT Approximately 1% of women with a molar pregnancy may have a recurrence. Chemotherapy is not indicated for recurrent molar pregnancies. An adequate interconception interval is important to ensure that the serum beta-human chorionic gonadotropin (β-hCG) from a new pregnancy does not interfere with the follow-up of the molar pregnancy that is done to detect persistent disease. We discuss the case of a nulliparous woman who had four molar pregnancies and her future reproductive options. How to cite this article Marakani LR, Gundabattula SR. Recurrent Molar Pregnancy: An Obstetric Dilemma? Int J Infertility Fetal Med 2012;3(2):63-64.

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