TỶ LỆ HÚT BUỒNG TỬ CUNG LẦN HAI VÀ MỘT SỐ YẾU TỐ LIÊN QUAN TRÊN ĐỐI TƯỢNG THAI TRỨNG TẠI BỆNH VIỆN TỪ DŨ

Abstract

Background: Uterine evacuation is the primary treatment modality for hydatidiform mole. Previously, a repeat uterine curettage is routinely performed  to ensure complete  removal of residual trophoblastic tissue. However, recent guidelines do not recommend routine second evacuation citing insufficient evidence of benefit in preventing malignant progression, and highlighting increased risks of complications and healthcare costs. In clinical practice, some cases still require a second uterine evacuation, yet few studies in Vietnam have evaluated the observed rate and associated factors of this intervention Objective: To determine the rate of second uterine evacuation and associated factors in patients with hydatidiform mole at Tu Du Hospital. Methods: A prospective case series study was conducted on 94 patients with histologically confirmed hydatidiform mole who returned for follow-up within 30 days after initial uterine evacuation at Tu Du Hospital between November 2024 and May 2025. Results: After 30 days of follow-up, 12 patients underwent a second evacuation, corresponding to a rate of 12.77% (95% CI: 6.77–21.24). The mean interval between the two evacuations was 18.33 ± 8.04 days, ranging from 7 to 30 days. The highest event rate was observed at the two-week follow-up. Multivariate analysis showed that second evacuation was more likely in patients with an initial evacuated tissue volume ≥ 300 mL ( OR = 17,40; p = 0,024) and serum β-hCG level at first follow-up ≥ 4303 mIU/mL (OR =98,13; p < 0,001). Conclusion: The rate of second uterine evacuation was 12.77%. An initial evacuated tissue volume ≥ 300 mL and a serum β-hCG level ≥ 4303 mIU/mL at the first follow-up visit were independently associated with an increased likelihood of repeat evacuation.