THE ROLE OF DOPPLER SONOGRAPHY IN ASSESSMENT OF MALIGNANT TROPHOBLASTIC DISEASE

An observational study on the role of Doppler sonography in the assess ment of patients with malignant trophoblastic disease was performed in an Oncology Unit of a University teaching hospital. A total of 32 con secutive patients referred for chemotherapy were recruited. Twenty-thr ee non-pregnant and 18 women in the first trimester of pregnancy acted as controls. The patients were prospectively followed-up for 2 years. It was found that the uterine arterial resistance index and pulsatili ty index in patients who required chemotherapy were significantly lowe r when compared with the non-pregnant and pregnant controls; (Student t-test; P < 0.001 and P < 0.01, respectively), Stepwise regression ana lysis of beta-hCG titres on uterine artery resistance index showed sig nificant correlation, after controlling for uterine volume (adjusted m ultiple R = 0.71, P < 0.00001). There were, however, no significant in dependent associations between the initial uterine artery resistance i ndex and the need for chemotherapy, number of courses of chemotherapy required, duration required for the beta-hCG titre to return to normal , presence of metastatic disease, or the subsequent development of dru g resistance or relapse. It was concluded that uterine arterial Dopple r indices are significantly correlated with trophoblastic activity (be ta-hCG titres) in malignant trophoblastic disease. However, their role in the prediction of subsequent tumour behaviour need to be assessed in larger series.