criteria for post molar GTN

SOGC/GOC Clinical Guideline #408, January 2021

Presence of one of the following criteria:
An increase in hCG of >10% from the previous level for 2 consecutive weeks (3 dosages on days 1, 8 and 15)
A change in hCG of <10% from the previous level for 3 consecutive weeks (4 measurements on days 1, 8, 15 and 22)
A diagnosis of choriocarcinoma on pathological examination
Evidence of metastatic disease
A serum hCG level of ≥20,000 mIU/ml more than 4 weeks post-evacuation

Comments

Improving patient outcomes depends on rapid referral and delegation of care for staging, risk scoring, and treatment.
Persistent low hCG is defined as an hCG level of <1,000 IU/L for at least 3 consecutive months without clear indication of an increasing or decreasing trend and without evidence of disease.
Persistent low hCG may occur in cases of true GTN, “quiescent” GTD, pituitary hCG production, or a false-positive hCG level (“phantom” hCG).
The use of hCG-H (CC, IHM) and free β subunit (PSTT) measurement requires validation by large prospective studies in order to define their role in the management of GTN.

2021. Guideline No. 408: Management of Gestational Trophoblastic Diseases. Eiriksson L, Dean E, Sebastianelli A, Salvador S, Comeau R, Jang JH, Bouchard-Fortier G, Osborne R, Sauthier Ph. J Obstet Gynaecol Can;43(1):91-105.

Modified on 12/23/2023