After suction evacuation of a complete hydatidiform mole, hCG plateau (less than 10% change over 3 consecutive weekly measurements) is noted at week 8. According to FIGO 2000, this necessitates treatment for:
- A Persistent gestational trophoblastic neoplasia (GTN) ✓
- B Malignant transformation to choriocarcinoma only if hCG is >5000 IU/L
- C Normal variation; hCG should be monitored until 20 weeks post-evacuation
- D Intraplacental trophoblastic tumour requiring hysterectomy
Correct answer: A. Persistent gestational trophoblastic neoplasia (GTN)
Explanation
FIGO criteria for GTN after molar evacuation include: hCG plateau (≤10% change over 4 weekly measurements), hCG rise (>10% over 3 consecutive weekly measurements), persistently elevated hCG at 6 months post-evacuation, or histological diagnosis of choriocarcinoma. A plateau at 8 weeks fulfils the criterion for persistent GTN and requires initiation of chemotherapy regardless of hCG level. Hysterectomy is not the first-line treatment in women who may desire future fertility.
Reference: Williams Obstetrics, 26th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.