Does hysteroscopy in women with persistent gestational trophoblastic disease reduce the need for chemotherapy? A prospective, single-arm, clinical trial pilot study

Abstract

BackgroundThis study aimed to describe the efficacy of hysteroscopy in the management of women with the persistent gestational trophoblastic disease (PGTD)/GTN to reduce the need for chemotherapy.Materials and methodsThis prospective, single-arm, clinical trial study was recruited in an educational referral hospital between September 2018 and September 2019. Totally, 30 participants with a history of hydatidiform mole that was managed by uterine evacuation and developed low risk persistent gestational trophoblastic disease were recruited. Hysteroscopy was performed for removal of persisted trophoblastic tissue. Serum beta-hCG titer was measured before and 7 days after the procedure.ResultsThe mean ± SD age of the participants was 31.4 ± 4.6 years. There was a significant difference (p = 0.06) between that mean ± SD of beta-hCG titer before (8168.4 ± 1758) and after (2648.8 ± 5888) hysteroscopy. Only two (6.6%) cases underwent chemotherapy due to no drop in the beta-hCG titer.ConclusionHysteroscopy may play a significant role in the management of GTN, although it requires validation in larger prospective randomized studies and longer follow-up.