Identification of patients with persistent trophoblastic disease by means of a normal human chorionic gonadotropin regression curve.
OBJECTIVE
Data from the Dutch Central Registry of Hydatidiform Mole were used to establish a reference human chorionic gonadotropin regression curve after molar pregnancy.


METHODS
A normal serum human chorionic gonadotropin regression corridor was constructed after fitting data from 130 patients with uneventful human chorionic gonadotropin regression after evacuation of a complete hydatidiform mole. Retrospectively, data from 77 patients with persistent trophoblastic disease were analyzed by means of this normal corridor. Measurements were performed with a radioimmunoassay for both native and free human chorionic gonadotropin beta-subunits.


RESULTS
Human chorionic gonadotropin disappearance curves showed a biphasic decline with median serum half-lives of 1.8 and 12.8 days. Median time until normalization was 74 days (range 28 to 430). With the 95th percentile line, 71 of 77 patients (92%) with persistent trophoblastic disease could be identified. In > 50% of cases this could be achieved within 6 weeks from evacuation.


CONCLUSIONS
The normal regression corridor allows identification of patients with persistent trophoblastic disease and an expectant attitude within the limits of the corridor.
Yedema
K A
KA
Department of Obstetrics and Gynecology, University Hospital Nijmegen, The Netherlands.
Verheijen
R H
RH
Kenemans
P
P
Schijf
C P
CP
Borm
G F
GF
Segers
M F
MF
Thomas
C M
CM
D006063:Chorionic Gonadotropin / Q000097:blood*; D018997:Chorionic Gonadotropin, beta Subunit, Human; D005260:Female; D006207:Half-Life; D006801:Humans; D006828:Hydatidiform Mole / Q000150:complications* / Q000601:surgery; D010446:Peptide Fragments / Q000097:blood; D011247:Pregnancy; D012189:Retrospective Studies; D014328:Trophoblastic Neoplasms / Q000097:blood / Q000175:diagnosis* / Q000209:etiology
D006063:Chorionic Gonadotropin; D018997:Chorionic Gonadotropin, beta Subunit, Human; D010446:Peptide Fragments