Minerva Obstetrics and Gynecology 2021 Sep 09

DOI: 10.23736/S2724-606X.21.04883-1

Copyright © 2021 EDIZIONI MINERVA MEDICA

lingua: Inglese

Predictive value of B-human chorionic gonadotropin for progression of molar pregnancy to persistent gestational trophoblastic neoplasm

Fariba YARANDI ¹, Mona MOHSENI ², Mahsa ALIKHASI ³, Sara RAMHORMOZIAN ⁴, Elham SHIRALI ¹ ✉

¹ Department of Obstetrics and Gynecology, School of Medicine, Yas Hospital, Tehran University of Medical Sciences, Tehran, Iran; ² Department of Obstetrics and Gynecology, School of Medicine, Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran; ³ Gynecologist, Tehran University of Medical Sciences, Tehran, Iran; ⁴ Department of Obstetrics and Gynecology Surgery, School of Medicine, Yas Hospital, Tehran University of Medical Sciences, Tehran, Iran

BACKGROUND: This study aimed to assess the predictive value of B-human chorionic gonadotropin (B-hCG) for progression of molar pregnancy to persistent gestational trophoblastic neoplasm (GTN).
METHODS: This cohort study evaluated 126 patients with molar pregnancy. The patients were selected among those presenting to Yas Hospital in 2016-2017. All female patients with molar pregnancy hospitalized in this hospital who underwent evacuation were enrolled. After evacuation, the patients underwent ultrasound examination to measure their endometrial thickness. Also, presence of complete or partial mole was pathologically assessed. The B-hCG titers were measured before and at 48 h, 1 week, 2 weeks, and 3 weeks after the evacuation. The follow-up was continued until the B-hCG titer was negative or the patient was classified as a case of GTN according to the FIGO classification. Data were analyzed by the independent t-test, Mann-Whitney test, Chi-square test, receiver operating characteristic (ROC) curve, and linear regression.
RESULTS: Of 126 patients with molar pregnancy, 13 developed GTN. The mean ratio of pre-evacuation B-hCG titer to the value at 3 weeks after evacuation was 0.02±0.005 in the full recovery and 0.06±0.04 in the GTN group, indicating an area under the curve (AUC) of 0.904.
CONCLUSIONS: The ratio of pre-evacuation B-hCG titer to the value at 3 weeks after the evacuation of mole can serve as an excellent predictor for development of GTN.

KEY WORDS: Gestational trophoblastic neoplasm; Molar pregnancy; B-human chorionic gonadotropin