Title:Comparative Investigation of Color Doppler Ultrasonography Parameters
of the Uterine Artery in Patients with Post-molar GTN and Patients
Recovered from Molar Pregnancy and its Role in Predicting the Probability
of Occurrence
Volume: 20
Issue: 3
Author(s): Malihe Hasanzadeh, Najmeh Jahani*, Sara Mirzaeian, Maryam Esmaeilpour and Marjaneh Farazestanian
Affiliation:
- Obstetrics and Gynecology Department, Faculty of Medicine, Birjand University of Medical Science, Birjand,
Iran
Keywords:
Gestational, trophoblastic, disease, doppler, ultrasound, choriocarcinoma.
Abstract:
Objectives: Hydatiform mole can progress to gestational trophoblastic neoplasia (GTN),
and we are looking for non-invasive methods to predict it. Old age, higher serum BHCG levels, and
expression of genes, such as VEGF-EG, HIF-1α, and TGF-ß are known as predictive factors. We performed
this study to evaluate the role of bilateral uterine artery doppler ultrasound in predicting postmolar-
GTN.
Methods: In this prospective cohort study, 42 patients with complete molar pregnancy were examined.
Inclusion criteria confirmed molar pregnancy by histopathological examination. Exclusion criteria
were patients more than 40 years old, patients with completed family childbearing planning, and diagnosis
of GTN during the routine histopathological study. Before molar evacuation and four weeks later,
bilateral uterine artery doppler sonography to determine the PI, RI, and PSV was performed. Serum
BHCG levels were also measured before molar evacuation and weekly after evacuation until it exhibited
spontaneous remission or developed GTN.
Results: About 36 patients were cured, and six others developed post-molar GTN. The bilateral uterine
artery doppler sonography between the two groups showed a lower UA RI in the post-molar-GTN
group before evacuation (P=0.048). Data demonstrated significant increases in Right.UA.RI
(P=0/008), Left.UA.PI (P=0/037), and Right.UA.PSV (P=0/024) in the spontaneous remission group
during 28 days follow-up period. There were no significant differences in these parameters in the GTN
group throughout the time of follow-up.
Conclusion: It seems that Doppler ultrasound plays a role in predicting GTN following uterine evacuation.
A lower resistance in the uterine artery before evacuation and the remaining uterine artery blood flow constant
after evacuation is associated with the development of post-molar- GTN.
