Lavie Isaac, Rao Gautam G, Castrillon Diego H, Miller David S, Schorge John O
Department of Obstetrics and Gynecology, University of Texas Southwestern Medical Center, Dallas 75390-9032, USA.
Am J Obstet Gynecol. 2005 May;192(5):1362-4. doi: 10.1016/j.ajog.2004.12.080.
Partial hydatidiform moles infrequently progress to gestational trophoblastic neoplasia. The purpose of this study was to determine the optimal duration of human chorionic gonadotropin surveillance.
We retrospectively reviewed the clinical follow-up of all women who were diagnosed with partial hydatidiform mole at our institution from 1983 to 2003.
One hundred sixty-three patients were identified with a median age of 23 years (range, 14-42 years). Seventy-four patients (45%) attained undetectable levels of human chorionic gonadotropin; none of the patients had gestational trophoblastic neoplasia. Forty patients completed the 6 months of recommended follow-up; 6 patients conceived during surveillance, and 28 patients did not return for any further office visits 1 to 5 months after achieving remission. Eighty-three patients (51%) were lost to follow-up before normalization of human chorionic gonadotropin. Six women (4%) had stage I gestational trophoblastic neoplasia during surveillance.
Our results support the suggestion that a single undetectable human chorionic gonadotropin level after evacuation is sufficient follow-up to ensure remission in patients with partial hydatidiform moles.
部分性葡萄胎很少进展为妊娠滋养细胞肿瘤。本研究的目的是确定人绒毛膜促性腺激素监测的最佳持续时间。
我们回顾性分析了1983年至2003年在我院诊断为部分性葡萄胎的所有女性的临床随访情况。
共确定163例患者，中位年龄23岁（范围14 - 42岁）。74例患者（45%）人绒毛膜促性腺激素水平降至检测不到；无一例患者发生妊娠滋养细胞肿瘤。40例患者完成了推荐的6个月随访；6例患者在监测期间受孕，28例患者在缓解后1至5个月未再复诊。83例患者（51%）在人绒毛膜促性腺激素恢复正常前失访。6例女性（4%）在监测期间发生I期妊娠滋养细胞肿瘤。
我们的结果支持以下建议，即清宫后人绒毛膜促性腺激素水平单次降至检测不到足以确保部分性葡萄胎患者缓解。
