title: Ultrasound imaging after evacuation as an adjunct to beta-hCG monitoring in posthydatidiform molar gestational trophoblastic neoplasia.
abstract: OBJECTIVE
  The purpose of this study was to identify prognostic factors associated with development of gestational trophoblastic neoplasia (GTN) after hydatidiform mole (HM).
  
  
  METHODS
  A retrospective analysis of 189 patients with HM was performed. We recorded features such as maternal age, HM history, blood group, gestational age, uterine volume at evacuation, presence of theca lutein cysts, vaginal bleeding, and transvaginal ultrasonography with color Doppler imaging. We considered risk predictors to be the presence of nodules and hypervascularization within the myometrium or endometrium (positive ultrasound imaging). An univariate and multivariate analysis, with the COX nominal logistic model, was performed.
  
  
  RESULTS
  Fourteen patients experienced GTN (7.4%). After univariate analysis, uterine size (P = .0139) and positive ultrasound results (P < .0001) were associated significantly with GTN development. At multivariate analysis, only positive ultrasound results maintained significance (likelihood ratio test: chi(2) = 0.0000).
  
  
  CONCLUSIONS
  The risk of GTN is increased in patients with uterine involvement that is assessed by ultrasound imaging. None of the other prognostic factors that were evaluated was predictive of GTN development.
authors.affiliation: Department of Gynecology and Obstetrics, IRCCS San Raffaele Hospital, Milan, Italy.
authors.forename: Elisabetta
authors.initials: E
authors.lastname: Garavaglia
authors.forename: Cinzia
authors.initials: C
authors.lastname: Gentile
authors.forename: Paolo
authors.initials: P
authors.lastname: Cavoretto
authors.forename: Daniele
authors.initials: D
authors.lastname: Spagnolo
authors.forename: Luca
authors.initials: L
authors.lastname: Valsecchi
authors.forename: Giorgia
authors.initials: G
authors.lastname: Mangili
mesh_terms: D000328:Adult; D018997:Chorionic Gonadotropin, beta Subunit, Human / Q000097:blood*; D005260:Female; D031901:Gestational Trophoblastic Disease / Q000097:blood* / Q000000981:diagnostic imaging*; D006801:Humans; D006828:Hydatidiform Mole / Q000097:blood; D011247:Pregnancy; D011379:Prognosis; D012189:Retrospective Studies; D014463:Ultrasonography; D014594:Uterine Neoplasms / Q000097:blood* / Q000000981:diagnostic imaging*; D055815:Young Adult
chemical_list: D018997:Chorionic Gonadotropin, beta Subunit, Human