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Oestradiol and FSH in gestational trophoblastic disease: a prospective analysis of their predictive value
Author(s) -
Macdonald Robert,
Kirwan John,
Thomson Catherine,
Hancock Barry,
Everard Jan,
Tidy John
Publication year - 2005
Publication title -
bjog: an international journal of obstetrics and gynaecology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.157
H-Index - 164
eISSN - 1471-0528
pISSN - 1470-0328
DOI - 10.1111/j.1471-0528.2005.00612.x
Subject(s) - medicine , hazard ratio , proportional hazards model , prospective cohort study , gynecology , confidence interval , population , obstetrics , environmental health
Objective To determine whether oestradiol or follicle‐stimulating hormone (FSH) measured prior to treatment could improve the predictive value of the risk score used to determine treatment in cases of persistent gestational trophoblastic disease (GTD). Design Prospective observational study. Setting Tertiary referral centre for GTD. Population All women referred to Weston Park Hospital, Sheffield, with GTD between 1st January 1996 and 31st December 2000. Methods Blood was taken prior to the initiation of treatment to measure oestradiol and FSH. The results were analysed with respect to the time taken for the β‐hCG to return to normal. Main outcome measures Time taken to reach a normal β‐hCG. Results Data on 118 women were collected. Three women died of GTD during follow up. Using Cox's proportional hazards regression analysis, division of the risk scores into high and low risk groups (≤7, >7) demonstrated a significant difference with regard to the length of time taken to reach a normal β‐hCG level (hazard ratio 0.32; 95% CI: 0.18, 0.57) comparing high risk relative to low risk. However, addition of neither oestradiol nor FSH to the Cox regression analysis produced a significant hazard ratio (Ln oestradiol, 0.95; FSH 0.99). Division of the patients' risk scores into three groups of low (0–4), intermediate (5–7) and high (>7) risk groups produced similar results. Conclusions The measurement of neither oestradiol nor FSH appears to improve the prediction of outcome in persistent GTD when added to the risk score.