Uterine Artery Doppler Ultrasound parameters for predicting the occurrence of persistent gestational trophoblastic disease (PGTD) after evacuation of complete hydatidiform mole, a prospective comparative cohort study

Document Type : Original Article

Authors

1 Department of Gynecology and Obstetrics, Zagazig University Faculty of Medicine, Zagazig, Egypt

2 Pathology Department, Faculty of Medicine, Zagazig University

Abstract

background: Pelvic Doppler ultrasound is considered an essential diagnostic tool for evaluating uterine size and blood flow in patients with gestational trophoblastic neoplasia. However, it is still controversial whether evaluation of Doppler flow velocimetry (DFV) parameters of uterine artery is a good predictor of gestational trophoblastic neoplasia after complete hydatiform mole evacuation.
Aim of the study was to compare uterine blood flow using Doppler ultrasound before and after evacuation of hydatiform mole between female patients with remissions and those with development of post-molar persistent gestational trophoblastic disease (PGTD) to detect accurate predictor factors of post-molar gestational trophoblastic malignancy.
Patients and methods: This is a prospective study included 80 females with complete hydatiform mole who underwent suction evacuation of uterine content, underwent uterine artery Doppler flow velocimetry (DFV) at admission and after vesicular mole evacuation.
We compare uterine blood flow using Doppler ultrasound before and after evacuation of hydatiform mole between female patients with remissions and those with development of post-molar persistent gestational trophoblastic disease (PGTD).
Results: 75% of included patients had spontaneous remission while remaining 20 (25%) patients had PGTD. Pre-evacuation RI and SD ratio (significantly lower in those who developed PGTD) and post-evacuation PI, (significantly higher in those who developed PGTD). PI was the Doppler parameter that was the most important associated factor with risk of PGTD.
Conclusions: uterine artery PI as the most important parameter which is related to higher risk of occurrence of PGTD after evacuation of complete hydatiform mole.

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