TRANSVAGINAL COLOR AND PULSED DOPPLER ASSESSMENT OF HYDATIDIFORM MOLE- A PRELIMINARY-REPORT

Objectives: The aim of this study was to evaluate the clinical potenti al of transvaginal color and pulsed Doppler in the assessment of hydat idiform mole. Methods: We studied eight cases of complete hydatidiform mole by transvaginal color and pulsed Doppler before primary evacuati on or hysterectomy. The uterine and peritumoral artery flow velocity w aveforms were evaluated in terms of resistance index. The presence of diastolic notch and outline profile of the uterine artery flow velocit y waveforms were also assessed. Results: Two patients developed clinic al invasive mole requiring systemic chemotherapy after evacuation, and in another patient a diagnosis of invasive mole was made histopatholo gically after hysterectomy (group A). The remaining five patients had a favorable clinical course after evacuation (group B). The resistance indices of the uterine and peritumoral artery flow velocity waveforms were significantly lower in group A than in group B (P < 0.01 and P < 0.02). Two patients with invasive mole who required systemic chemothe rapy had low pulsatile and spiky outline flow velocity waveforms witho ut a diastolic notch in the uterine arteries before primary evacuation . Conclusions: Transvaginal color and pulsed Doppler assessment of the uterine artery flow velocity waveforms in hydatidiform mole may allow prediction of high risk molar pregnancies that develop into persisten t trophoblastic disease before primary intervention.