Does Hysteroscopy in Women with Persistent Gestational Trophoblastic Disease Reduce the Need for Chemotherapy? A Prospective, Single Arm, Clinical Trial Pilot Study

Background: This study aimed to describe the efficacy of hysteroscopy in the management of women with persistent gestational trophoblastic disease to decrease the chemotherapy need. Materials: and methods: This prospective, single-arm, clinical trial study was conducted at a tertiary educational referral hospital between September 2018 and September 2019. In the follow-up of the patients diagnosed with hydatidiform mole and managed by uterine evacuation, 30 cases developed low risk persistent gestational trophoblastic disease. Hysteroscopy was performed for removal of persisted trophoblastic tissue, before chemotherapy. Serum beta-hCG titer was measured before and 7 days after the procedure. Results: Mean±SD age of the participants was 31.4±4.6 years. There was a significantly difference (p=0.06) between that mean±SD of beta-hCG titer before (8168.4±1758) and after (2648.8±5888) treatment. Two (6.6%) cases needed chemotherapy due to no decrease in beta-hCG titer. Conclusion: Although, hysteroscopy may play a significant role in the management of persistent gestational trophoblastic disease but requires validation in larger prospective randomized studies and longer follow-up.