Premium
Analysis of risk factors for persistent gestational trophoblastic disease
Author(s) -
KHOO SooKeat,
BAARTZ David,
SIDHU Mukhtiar,
YIP WaiLum,
TRIPCONY Lee
Publication year - 2009
Publication title -
australian and new zealand journal of obstetrics and gynaecology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.734
H-Index - 65
eISSN - 1479-828X
pISSN - 0004-8666
DOI - 10.1111/j.1479-828x.2009.01085.x
Subject(s) - medicine , molar pregnancy , gestation , pregnancy , obstetrics , gestational trophoblastic disease , hazard ratio , disease , relative risk , multivariate analysis , cohort , risk factor , human chorionic gonadotropin , gynecology , confidence interval , genetics , hormone , biology
Setting: Persistent disease is a serious consequence of molar pregnancies. Its early detection is critical to effective chemotherapy. Therefore, determination of risk becomes an important clinical decision. Objectives: To determine the relative risk of persistent disease in a cohort of patients with partial and complete molar pregnancies by analysis of five factors derived from a database using multivariate analysis. Results: Of 686 patients, 78 developed persistent disease which required treatment (rate of 11.3%). Risk was markedly increased when serum human chorionic gonadotrophin (HCG) failed to reach negative by 12 weeks after evacuation [hazard ratio (HR) = 120.78, P < 0.001]. Risk was markedly decreased when the interval from last pregnancy exceeded 12 months (HR = 0.24, P = 0.005). Other factors such as patient’s age, stage of gestation and serum HCG level at presentation were not found to be strongly associated with risk of persistent disease. Conclusion: These findings support the application of the following two factors in risk prediction for molar pregnancies: > 12 weeks to become HCG negative and interval from last pregnancy < 12 months. They will contribute to a greater awareness of persistent disease and assist in early detection and effective chemotherapy.