[On the results of hydatidiform mole managed by Niigata method].

We have managed 518 cases of total mole patients in our Ob-Gyn clinic in the past 13 years by the Niigata postmole management method. Serial urinary hCG determination by sensitive assay (Higonavis and RIA) is the key examination in it. There are two critical points of urinary hCG determination: 1,000iu/L at the 5th week and 100iu/L at the 8th week after the termination of hydatidiform mole. The urinary hCG patterns are classified into type I if the hCG regression curve falls below both of them, and into type II if it follows curves other than type I. Among 89 cases of postmole patients who were administered no anti-cancer chemotherapy, 73 cases (82%) showed a type I hCG regression pattern, eight cases of which (11%) were complicated mole such as metastatic mole and invasive mole. Sixteen cases (18%) showed type II, but 8 of them (50%) were diagnosed as uncomplicated mole. The rate of complication among 118 cases of hydatidiform mole who had a molar pregnancy terminated and were followed up totally in our clinic was 24.6% and that of referral cases after molar evacuation was 21.3%, which is significantly higher than others reported in literature. There occurred no postmolar choriocarcinoma from uncomplicated mole patients who had their LH level confirmed in their urinary hCG determination, but 1 case (2.7%) did occur from LH level confirmed metastatic mole, and 3 cases (3.9%) from LH level confirmed metastatic invasive mole. It was shown that lung shadows on chest roentgenogram mostly take about 40 days to appear after D & C of hydatidiform mole and after surgery for uterine invasive mole.(ABSTRACT TRUNCATED AT 250 WORDS)