Ultrasonographic vascular indices in the post-evacuation assessment of complete hydatidiform mole and gestational trophoblastic neoplasia.

AIM: To identify clinical, biochemical, and ultrasonographic parameters that may serve as early predictors of gestational trophoblastic neoplasia (GTN) in patients initially diagnosed with complete hydatidiform mole (CHM).

MATERIAL AND

METHODS

This retrospective study included 47 patients with trophoblastic gestational disease, of whom 28 had CHM and 19 developed GTN. Clinical data, serum human chorionic gonadotropin (hCG) levels, and ultrasonographic parameters-including vascular index (VI) (MV-Flow®) and uterine artery pulsatility index (PI)-were collected and analyzed. Logistic regression and receiver operating characteristic (ROC) curve analyses were used to assess predictive value.

RESULTS

GTN patients had significantly higher rates of second uterine evacuation (47.4% vs. 7.1%, p=0.001), prolonged time to hCG normalization (92.0 vs. 40.0 days, p<0.001), and increased frequency of focal lesions (68.4% vs. 14.3%, p<0.001). VI values in the longitudinal, transverse, and mean uterine planes were significantly higher in GTN, while mean PI was significantly lower (1.61 vs. 3.13, p=0.001). ROC curves demonstrated good diagnostic performance for the mean VI (AUC=0.823) and mean PI (AUC=0.777).

CONCLUSION

The VI and uterine artery PI, in combination with serum hCG dynamics and focal lesion detection, may serve as useful parameters in the early identification of patients at increased risk for neoplastic progression following molar pregnancy.