A woman with a complete hydatidiform mole underwent suction evacuation. Post-evacuation β-hCG was 45,000 IU/L. Surveillance β-hCG values over 3 weeks are: 40,000 → 38,500 → 39,200 IU/L. According to FIGO 2002 criteria, this pattern indicates need for treatment because of:
- A β-hCG plateau (< 10% change over 3 consecutive weekly measurements) ✓
- B β-hCG rise of > 10% over 2 consecutive weekly measurements
- C β-hCG not reaching < 5 IU/L by 8 weeks post-evacuation
- D β-hCG rise of > 200 IU/L from a previous measurement
Correct answer: A. β-hCG plateau (< 10% change over 3 consecutive weekly measurements)
Explanation
FIGO 2000/2002 criteria for diagnosing gestational trophoblastic neoplasia requiring treatment include: (1) β-hCG plateau (≤ 10% fall over 3 consecutive weekly assays), (2) β-hCG rise ≥ 10% over 2 consecutive weekly assays, (3) persistent β-hCG > 6 months after molar evacuation, (4) histological diagnosis of choriocarcinoma. In this patient, values of 40,000 → 38,500 → 39,200 show < 10% change across 3 measurements — this constitutes a plateau and meets criterion 1 for GTN treatment.
Reference: Shaw's Textbook of Gynaecology, 17th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.