Earlier diagnosis and serum human chorionic gonadotropin regression in complete hydatidiform moles.

Abstract

OBJECTIVE: To estimate serum human chorionic gonadotropin (hCG) regression in uneventful complete hydatidiform moles before and after the introduction of routine first-trimester ultrasonography. METHODS: Gestational age, maternal age, preevacuation hCG concentrations, serum hCG regression, and hCG disappearance time among a recent group of 137 women with uneventful complete hydatidiform moles that were found between 1994 and 2006 were evaluated retrospectively and compared with a historical cohort of 106 patients with complete moles that were found between 1977 and 1989. RESULTS: Gestational age, preevacuation hCG concentration, and hCG disappearance time were significantly lower in the recent complete hydatidiform mole cohort compared with the historic series. Ninety-nine percent of the recent cohort achieved hCG normalization within 19 weeks after uterine evacuation compared with 25 weeks in the historic group. CONCLUSION: Earlier serum hCG regression in the recent cohort of complete hydatidiform moles probably is a result of widely used first-trimester ultrasonography leading to detection and evacuation of complete moles at younger gestational ages, resulting in lower hCG levels at time of evacuation. LEVEL OF EVIDENCE:: II.