title: Diagnostic and therapeutic curettage in gestational trophoblastic disease.
abstract: From June 1976 through June 1989, 37 nonconsecutive patients underwent uterine curettage during the course of their gestational trophoblastic disease. In 22 patients (59%) trophoblastic tissue was obtained. Three (8.1%) patients sustained a uterine perforation during the procedure. In six patients curettage was performed for bleeding. There were six patients curetted during assessment for metastatic trophoblastic disease. Twenty-eight patients underwent curettage for the presumed diagnosis of nonmetastatic gestational trophoblastic disease. In retrospect, four of these women (14.3%) had insufficient criteria for the diagnosis of gestational trophoblastic disease. Of the remaining 23 patients, four (17.4%) went into clinical remission without further treatment. Ten patients (43.5%) had a transitory decline in serum beta-human chorionic gonadotropin levels that subsequently rose or plateaued. Six patients (26.1%) showed no effect from the curettage on their serum beta-human chorionic gonadotropin trend during a short period of observation. Three patients (13.0%) with nonmetastatic gestational trophoblastic disease were not observed for a possible therapeutic effect after curettage. Thus, in only 4/20 (20%) women with nonmetastatic trophoblastic disease was a therapeutic effect from curettage shown.
authors.affiliation: Department of Obstetrics and Gynecology, University of Southern California School of Medicine, Los Angeles.
authors.forename: J B
authors.initials: JB
authors.lastname: Schlaerth
authors.forename: C P
authors.initials: CP
authors.lastname: Morrow
authors.forename: M
authors.initials: M
authors.lastname: Rodriguez
mesh_terms: D006063:Chorionic Gonadotropin / Q000097:blood; D003475:Curettage; D005260:Female; D006801:Humans; D011247:Pregnancy; D012189:Retrospective Studies; D014328:Trophoblastic Neoplasms / Q000097:blood / Q000175:diagnosis / Q000601:surgery*; D014592:Uterine Hemorrhage / Q000601:surgery; D014594:Uterine Neoplasms / Q000097:blood / Q000175:diagnosis / Q000601:surgery*; D014599:Uterus / Q000601:surgery
chemical_list: D006063:Chorionic Gonadotropin