A 28-year-old woman underwent suction evacuation for a complete hydatidiform mole four weeks ago. Her serum beta-hCG was 85,000 mIU/mL at evacuation. Current beta-hCG is 45,000 mIU/mL. She is asymptomatic. According to FIGO criteria, which of the following findings would indicate the need for chemotherapy?
- A Beta-hCG >20,000 mIU/mL at 4 weeks post-evacuation
- B Plateaued or rising beta-hCG over three consecutive weeks ✓
- C Beta-hCG decline <50 percent over 2 weeks
- D Beta-hCG detectable at 8 weeks post-evacuation
Correct answer: B. Plateaued or rising beta-hCG over three consecutive weeks
Explanation
FIGO criteria for diagnosing post-molar gestational trophoblastic neoplasia requiring chemotherapy include: plateaued or rising beta-hCG over three consecutive weeks, histologic evidence of choriocarcinoma, or beta-hCG persistence beyond 6 months. B single elevated value or slow decline alone does not mandate treatment. This distinction prevents unnecessary chemotherapy in patients with expected slow resolution.
Reference: Williams Obstetrics, 26th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.