Transvaginal color Doppler studies in gestational trophoblastic disease

Three women with gestational trophoblastic disease were examined using transvaginal color Doppler at the initial diagnosis and after each course of chemotherapy. In all cases, the examination before chemotherapy revealed hypoechoic areas surrounded by irregular echogenic areas and numerous intramyometrial flow signals. Pulsed Doppler examination revealed a low pulsatility index (PI) in the uterine arteries. After the completion of chemotherapy, a decrease in the vascularity and increase in the PI of the uterine arteries were demonstrated in two cases. These findings were closely consistent with the decrease in serum levels of beta-human chorionic gonadotropin. However, in the patient who developed permanent arteriovenous communication, hypervascularity persisted and the PI of the uterine arteries remained low, even after clinical remission was achieved. The present study indicates that transvaginal color Doppler ultrasonography is useful for the evaluation of gestational trophoblastic disease, both at the time of diagnosis and after chemotherapy.