According to standard guidelines, which of the following is an indication for prophylactic chemotherapy following evacuation of a complete hydatidiform mole?

• A Uterus size corresponding to 14 weeks gestation
• B Maternal age of 32 years
• C First episode of mild vaginal bleeding
• D Pre-evacuation β-hCG of 200,000 IU/L ✓

Explanation

Prophylactic chemotherapy (usually single-agent methotrexate or actinomycin C) is considered in high-risk complete mole patients who have difficulty with follow-up or high-risk features. These include hCG >100,000 IU/L, excessive uterine enlargement, theca lutein cysts >6 cm, and age >40. An hCG of 200,000 IU/L is markedly elevated and constitutes a high-risk indication. Mild bleeding and age 32 alone are not indications.

Reference: Williams Obstetrics, 26th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.