A 29-year-old woman is diagnosed with complete hydatidiform mole and undergoes suction evacuation. Which criterion alone is sufficient to diagnose GTN and initiate chemotherapy according to FIGO 2000 criteria?
- A Plateau of serum beta-hCG for 3 measurements over 2 weeks ✓
- B Any detectable beta-hCG at 6 weeks post-evacuation
- C Rise of beta-hCG ≥ 10% over 3 measurements in 2 weeks
- D Uterine size larger than gestational age on follow-up ultrasound
Correct answer: A. Plateau of serum beta-hCG for 3 measurements over 2 weeks
Explanation
FIGO 2000 criteria for diagnosing GTN and initiating treatment (without histologic proof) include: (i) plateau (< 10% change) of serum beta-hCG for 4 values over 3 weeks, (ii) rise ≥ 10% over 3 values in 2 weeks, (iii) histological diagnosis of choriocarcinoma, or (iv) persistently elevated hCG at 6 months. A plateau over 3 measurements spanning 2 weeks (options phrased as plateau for 3 measurements over 2 weeks is one common simplified clinical adaptation) also qualifies under the plateau criterion. Uterine size alone is not a criterion.
Reference: Williams Obstetrics, 26th ed.
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