Uterine artery Doppler blood flow in cases of hydatidiform mole and its correlation with beta-hCG.

OBJECTIVES

To study the correlation between Doppler blood flow and beta-human chorionic gonadotropin (hCG), to assess the course of the disease and the follow up evaluation.

SETTING

This study was conducted in Assiut University Hospital, Department of Obstetrics and Gynecology.

DESIGN

Longitudinal study.

SUBJECTS AND

METHODS

Fifteen cases of vesicular mole were recruited and followed up. The patients were evaluated the day before evacuation of the uterus. This included clinical assessment, Doppler uterine artery blood flow velocity waveforms using the Doppler indices and assessment of the serum level of beta-hCG. These cases were followed up every 2 weeks in the first 2 months, and every month thereafter until the 6 month.

RESULTS

Twelve patients showed continuous decrease in beta-hCG level from 1192+/-697 to 6+/-11 IU/ml by the end of the second month. Systolic-diastolic (S/D) increased from (2.57+/-1.13) to (15.9+/-2.07) (P<0.0001), RI increased from 0.55+/-0.15 to 1.0+/-0.26(P<0.0001) and PI increased from 1.02+/-0.47 to 6.12+/-2.34 (P<0.0001). One patient showed a fluctuating level of beta-hCG around the same level, and two showed a slowed decrease. Doppler indices showed similar results. There is a strong correlation between beta-hCG and all Doppler indices throughout the course of follow up: beta-hCG and S/D r<0.01, beta-hCG and RI r<0.01 and beta-hCG and PI r<0.01.

CONCLUSION

Doppler ultrasound can be used as an adjuvant tool in the follow up of cases of vesicular mole and can predict the progress in the course of the disease.