Obstetrics & Gynaecology · Ectopic Pregnancy and Gestational Trophoblastic Disease

According to FIGO 2000 criteria, gestational trophoblastic neoplasia (GTN) is diagnosed after a molar evacuation when serum beta-hCG shows which pattern?

  • A A plateau (less than 10% change) over 3 consecutive weekly measurements over ≥3 weeks, OR a rise of ≥10% over 2 consecutive measurements over ≥2 weeks, OR persistence at 6 months, OR histological diagnosis of choriocarcinoma
  • B Any detectable beta-hCG beyond 8 weeks post-evacuation
  • C Beta-hCG doubling time less than 48 hours post-evacuation
  • D Beta-hCG above 5000 mIU/mL at 4 weeks post-evacuation
Correct answer: A. A plateau (less than 10% change) over 3 consecutive weekly measurements over ≥3 weeks, OR a rise of ≥10% over 2 consecutive measurements over ≥2 weeks, OR persistence at 6 months, OR histological diagnosis of choriocarcinoma

Explanation

FIGO 2000 diagnostic criteria for GTN post-mole: (1) hCG plateau (±10%) over 3 weekly values over ≥3 weeks; (2) hCG rise ≥10% over 2 consecutive weekly values over ≥2 weeks; (3) hCG persistence at 6 months post-evacuation; (4) histological diagnosis of choriocarcinoma or PSTT/ETT. Any one of these criteria diagnoses GTN and mandates treatment initiation without histological confirmation from hysterectomy.

Reference: Williams Obstetrics, 26th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

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