Molar Gebeliklerde Tedavisi Sonrasında Serum β-hCG Klirensinin Değerlendirilmesi

Amaç: Komplet ve Parsiyel Mol tanısıyla tedavi edilen hastaların klinik özellikleri ile birlikte tedavi sonrası takiplerinde serum β-hCG değerinin normale dönmesine kadar geçen süreyi değerlendirmek.Gereç ve Yöntemler: 2010 Ocak ile 2018 Ocak arasında hastanemizde Komplet Mol ve Parsiyel Mol tanısı ile suction küretaj yapılmış hastaların dosyaları retrospektif olarak incelendi. Hastaların yaş, parite, tedavi öncesi serum β-hCG değeri, tedavi sonrası takiplerinde negatif serum β-hCG değeri elde edilinceye kadar geçen süre, tedavi ile kür sağlanan hasta sayısı ile persiste hastalık gelişen olgular kaydedildi.Bulgular: Toplam 44 hastanın 29 %65.9 ’una Komplet Mol, 15 %34.1 ’ine ise Parsiyel Mol tanısıyla suction küretaj yapıldı. Komplet Mol grubunda tedavi sonrası takiplerine ulaşılabilen 25 hastadan 22 %88 ’sinde primer tadavi ile kür sağlanırken 3 %12 hastada persiste hastalık oluştu. Parsiyel Mol grubunda ise takiplerine ulaşılan 13 hastanın 11 %84.6 ’inde kür sağlandı ve 2 %15.4 hastada persistans oluştu. Tedavi öncesi Komplet Mol grubunda median serum β-hCG düzeyi 187.924 48.956 – 635.982 mIU/ml olup tedavi sonrasında ortalama 8 haftada hastalarda normal serum β-hCG değeri elde edildi. Parsiyel Mol grubunda ise median serum β-hCG 90.258 30.569- 165.241 mIU/ml bulundu ve ortalama 10 haftada hastalar negatif serum β-hCG değerine ulaşıldı.Sonuç: Mol gebeliğin boşaltılmasından sonra üç negatif serum β-hCG değeri elde edilinceye kadar haftalık sonrasında da düzenli olarak serum β-hCG takibi yapılması persiste hastalığın erken tanısında ve gestasyonel trofoblastik hastalıkların tedavi sonrası yönetiminde kritik önemdedir.

Anahtar Kelimeler:

Komplet mol, parsiyel mol, serum β-hCG

Evaluation Of Serum Beta Human Chorionic Gonadotrophin Clearance Following Treatment Of Molar Pregnancies

Aim: We aimed in this study to identifty the normalization time of serum beta human gonadotrophin β-hCG levels following the treatments of complete and incomplete molar pregnancies along with the clinical characteristics of patients.Material and Methods: The medical records of patients who underwent suction curettage for indications of complete and incomplete molar pregnancies in our hospital between January 2010 and January 2018 were reviewed retrospectively. Patient’s ages, parities, pretreatment β-hCG levels, durations of return of β-hCG level to normal and the number of patients cured with treatment and persisted cases were picked.Results: In total 44 patients, suction curettage was done for 29 65,9% and 15 34,15% patients with the diagnoses of complete and incomplete molar pregnancies, respectively. As cure was rendered with primary treatment for 22 88% patients in complete molar pregnancy group of 25 patients whose follow-up records handled, three 12% cases were persisted. In incomplete molar pregnancy group of 13 patients, 11 84,6% got cure and two 15,4% persisted. For the complete molar pregnancies the median serum β-hCG level before treatment was 187.924 48,956- 634,982 mIU/ml and at an average of eight weeks negative serum β-hCG levels were obtained. For the incomplete molar group, the median serum β-hCG level before treatment was 90,258 30,569-165,241 mIU/ ml and the mean normalization time for bhcg levels was 10 weeks.Conclusion: Following the suction of molar pregnancies, regular measuring of the serum β-hCG levels untill a negative result up to three weeks has a critical role in the early diagnosis of persisted disease and posttreatment management of gestational trophoblastic diseases.

Keywords:

Complete molar pregnancy, incomplete molar pregnancy, serum β-hCG,

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