[Clinical study of four cases with malignant gestation trophoblastic tumor after mifepristone abortion].
OBJECTIVE
To describe the clinical characteristics of malignant gestational trophoblastic tumor after medical abortion used by mifepristone combined with misoprostol and its diagnosis and differential diagnosis from incomplete abortion.


METHODS
Four cases with malignant gestational trophoblast tumor after medical abortion were presented focusing on the clinical manifestation and the methods of diagnosis and differential diagnosis.


RESULTS
Irregular vaginal bleeding and abnormal high level of beta-human chorionic gonadotropin (hCG) in plasma were the common manifestation of the gestational trophoblast tumour and incomplete abortion after medical abortion. However, beta-hCG of the former after curettage was still higher by dynamic monitoring. Malignant gestational trophoblast tumor showed rich blood flow signal and low blood flow resistance index (RI, RI < 0.5) in uterus in color doppler echography, digital subtraction angiography (DSA) with abnormal enlargement of the arteria of uterine, arteriovenous fistula beside the uterine were the main characteristics of malignant gestational trophoblast tumour.


CONCLUSIONS
Pay attention to the early stage malignant gestational trophoblast tumour among patients with abnormal vaginal bleeding after medical abortion. beta-hCG and DSA were the most effective methods to diagnose and differentially diagnose choriocarcinoma from the incomplete abortion among the patients with abnormal vaginal bleeding after medical abortion.
Jin
L
L
Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Science, Beijing 100730, China.
Fan
G
G
Yang
X
X
D000021:Abortifacient Agents, Steroidal / Q000009:adverse effects*; D000027:Abortion, Incomplete / Q000175:diagnosis; D000028:Abortion, Induced / Q000009:adverse effects*; D000328:Adult; D015901:Angiography, Digital Subtraction; D006063:Chorionic Gonadotropin; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D008875:Middle Aged; D015735:Mifepristone / Q000009:adverse effects*; D011247:Pregnancy; D014328:Trophoblastic Neoplasms / Q000139:chemically induced* / Q000175:diagnosis; D018608:Ultrasonography, Doppler
D000021:Abortifacient Agents, Steroidal; D006063:Chorionic Gonadotropin; D015735:Mifepristone