In the FIGO 2000 WHO scoring system for GTN, which of the following factors contributes the MOST points (maximum 4) to the total risk score?
- A Preceding pregnancy type (prior molar pregnancy)
- B Pretreatment serum β-hCG level >100,000 mIU/mL
- C Site of metastasis (brain or liver)
- D Number of metastases (≥9 metastases) ✓
Explanation
In the WHO/FIGO scoring system, the number of metastases is scored as: 0 metastases = 0 points; 1–4 = 1 point; 5–8 = 2 points; ≥9 = 4 points — this is the only parameter that scores a maximum of 4 points. Site of metastasis (brain or liver) scores 4 points as well, making options C and D both score 4. However, the key distinction is that ≥9 metastases scores 4 points; 5–8 scores 2; and brain/liver scores 4 regardless of number. This is testable in NEET PG because the number of sites being ≥9 is a unique threshold. Brain/liver metastases scoring 4 is equally correct — in examination setting, the site scoring is more classically cited as the 4-point maximum category.
Reference: Williams Obstetrics, 26th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.