The contribution of 2D ultrasonography and Doppler in persistent gestational trophoblastic disease diagnosis and monitoring

Abstract

OBJECTIVE: To describe the contribution of 2D and Doppler ultrasonography in the diagnosis and follow-up of persistent gestational trophoblastic disease (GTDp). MATERIALS AND METHODS: Literature review. We searched the online PubMed and BVS databases for articles published in the last 5 years with the following keywords: Gestational trophoblastic disease and ultrasonography, Doppler and gestational trophoblastic disease / diagnostic imaging * and ultrasonography / methods. We retrieved nineteen articles. After reading the abstracts, we chose 11 articles to compose this review. RESULTS: The adoption of routine ultrasonography in the first trimester of pregnancy has allowed the early diagnosis of GTDp before significant hydropic changes. The staging done with the pelvic Doppler has been fundamental in the evaluation of the choice of the antineoplastic treatment and in the monitoring of the resistance to the chemotherapeutics. A resistance index of less than 0.4 and a pulsatility index of less than 1.5 are indicative of a low resistance uterine artery, typical of GTDp. CONCLUSION: Ultrasonography continues to be the first line exam in the diagnosis and follow - up of GTDp. When combined with Doppler flowmetry, it is useful both in the initial evaluation and in the follow-up of the response to treatment and detection of relapse.