HCG decline trend after hydatidiform mole curettage

Mole is very common in normal times, but if it occurs, uterine curettage is generally required. However, after uterine curettage, the HCG of women generally decreases, and the decrease is relatively stable. However, once the HCG decrease of mole is abnormal, it is necessary to seek medical attention in time. Many moles have the phenomenon of malignant transformation. What is the downward trend of hCG after uterine curettage of mole?

HCG decrease trend after hydatidiform mole curettage

Under normal circumstances, after the hydatidiform mole is emptied, serum hCG decreases steadily. The average time for the first drop to normal is 9 weeks, and the longest time is no more than 14 weeks.

Judging from the changes in blood HCG after hydatidiform mole curettage, as long as it is on a downward trend overall, it is okay. Regular review is recommended.

Generally, blood hCG levels decrease after medication treatment for hydatidiform mole. So, what should we do if the hCG level of hydatidiform mole rises? Under normal circumstances, after the hydatidiform mole is emptied, the serum hCG will steadily decrease. The average time for the first drop to normal is 9 weeks, and the longest time is no more than 14 weeks. If hCG remains abnormal after the mole is evacuated, gestational trophoblastic tumor should be considered. High-risk hydatidiform mole should be considered when the following high-risk factors are present: hCG>100,000U/L; the uterus is significantly larger than the corresponding gestational age; the diameter of the ovarian luteinized cyst is>6 cm or bilateral luteinized cysts; age 40 years old; small hydatidiform mole; history of repeated hydatidiform mole; pregnancy complications: hyperemesis gravidarum, hyperthyroidism, etc.

There is a 10% to 20% chance of malignant transformation in patients with hydatidiform mole, so patients with hydatidiform mole should be followed up regularly. In particular, following up the changes in HCG in urine or blood can help detect malignant tendencies at an early stage, which is particularly important for the prognosis of the disease. After hydatidiform mole curettage, urine must be checked once a week until the urine pregnancy test is negative, then once a month, and once every 3 months after 6 months, with at least 2 years of follow-up. The patient can become pregnant again only after completing the follow-up.

To prevent the recurrence of hydatidiform mole, it is important to pay attention to follow-up after treatment. After evacuation of hydatidiform mole, hCG should be measured once a week until 3 consecutive negative results, and then once a month for at least half a year. Thereafter, follow-up can be conducted every six months for a total of 2 years. During follow-up, special attention should be paid to changes in hematuria and HCG. Gynecological examinations should also be performed to understand the state of uterine involution and to note whether the patient has abnormal vaginal bleeding, hemoptysis, or other symptoms of metastatic lesions. Pelvic ultrasound, chest X-ray or CT examination are also performed.

What are the changes of hcg during pregnancy

hCG enters the mother's blood around the sixth day after fertilization and proliferates rapidly until the eighth week of pregnancy, then slowly decreases in concentration until the 18th to 20th week, then maintains for about 10 days and begins to decline (but still above normal levels). Generally, an increase in intact hCG levels to at least 2.5MoM is associated with Down syndrome. However, the actual average level of complete hCG in the maternal blood of DS patients is only 1.3MoM, which cannot clearly identify DS patients.

The hCG-related molecules used for DS examination are free b-hCG and high sugar hCG (H-hCG). H-hCG-related molecular screening for Down syndrome is sensitive and can be performed using urine sampling. The plasma H-hCG concentration in mothers of DS children was 9.9-fold higher than that in non-infected pregnant women.

Free b-hCG is the only known marker that can be used for both primary and secondary screening. The average level of free b-hCG in the blood of mothers with DS syndrome is 1.9MoM, while that in the blood of healthy mothers is 1.0MoM. The levels of hCG-related molecules are also related to the sex of the fetus, with hCG levels in baby girls being significantly higher than in baby boys.

The complete HCG is produced entirely by the syncytiotrophoblast of the placental chorion. Its main function is to stimulate the corpus luteum, which is beneficial to the continuous secretion of estrogen and progesterone, so as to promote the formation of uterine decidua and make the placenta grow and mature. It is now believed that HCG is produced by trophoblast transitional cells and syncytial cells. HCG begins to be secreted about 6 days after fertilization and reaches its peak around 60-70 days. It increases rapidly during the first 8 weeks of pregnancy to maintain the pregnancy. After about 8 weeks of pregnancy, HCG gradually decreases until it reaches relative stability around 20 weeks.