A 40-year-old woman complains of irregular bleeding for 7 months after delivery of her fourth baby. Curettage is performed and histology reveals a choriocarcinoma. Her serum beta hCG level is 2x105 IU/L.What is the most appropriate next step in the management?
Ans. is b, i.e. Commence treatment with multi-agent combination chemotherapyThis woman is at high risk as she has a prognostic score of 7:Antecedent normal pregnancy - 2Age more than 40 years - 1Antecedent pregnancy 7 months ago - 2Serum hCG level 2x105-2Therefore, she needs treatment with multi-agent comnination chemotherapy with EMA-CO.
Commence treatment with intramuscular methotrexate
Commence treatment with multi-agent combination chemotherapy
Perform a hysterectomy
Repeat serum hCG after 4 weeks
Gestational Trophoblastic Disease