The following is a summary of “Effect of single-dose methotrexate injection to prevent neoplastic changes in high-risk complete hydatidiform mole: A randomized control trial,” published in the October 2022 issue of Primary care by Biswas, et al.
Women of childbearing age are more susceptible to complete hydatidiform moles. A delayed (beyond 56 days) return to normal serum HCG following a surgical evacuation was associated with persistent molar gestational trophoblastic neoplasia (GTN), which affects about 15-20% of cases. For a study, researchers sought to reduce the amount of time needed for βHCG to return to normal in women with high-risk complete hydatidiform moles (CHM) following suction evacuation.
A total of 76 CHM patients were randomly assigned to intervention and control groups. Following the evacuation, women in the intervention arm (n = 34) got a single 100 mg intramuscular dose of methotrexate, whereas those in the control group (n = 42) received conventional care. In both groups, surveillance was carried out every two weeks over the following six months, and the length of time that the βHCG level took to normalize was noted.
Women completed follow-up in total at 94.7%. When compared to the controls, the intervention group’s mean normalization time was considerably shorter (9.7 weeks versus 14.7 weeks; P< 0.01). Time to event curve revealed that the intervention group’s cumulative normalization time was much sooner.
A low-cost, straightforward remedy called a single-dose 100 mg methotrexate injection has been shown to assist one in three women with CHM, and high-risk characteristics normalize their HCG levels within 56 days. People in resource-poor nations with low adherence to prolonged observation may find this useful.