Regular measurements of the serum ßHCG levels are the most important part of the follow-up surveillance for molar pregnancies. The levels are monitored weekly until normal—usually, the level progressively declines to normal within 14 weeks after the D&C—then monthly for 6 to 12 months.
• A gynecologic examination and careful physical examination is done one week after the D&C and then every
four weeks until the ßHCG titer returns to normal or unless symptoms develop.
• Contraception (preferably oral contraceptives) should be used for 6 to 12 months after the D&C.
The serum ßHCG levels are also monitored for other types of GTD. Once the ßHCG titer returns to normal after treatment, the levels should be measured monthly for one year in the case of non-metastatic disease or two years for metastatic disease.
Pregnancy After GTD Treatment Future pregnancies are not significantly affected by the chemotherapy used in the treatment of GTD. There does not seem to be a higher infertility rate, a lower chance for a successful term pregnancy or a higher rate of spontaneous abortion. There is a higher incidence of subsequent GTD.
Most physicians recommend avoiding pregnancy for the first year after a hydatidiform mole is treated. This will prevent any confusion about the interpretation of elevated ßHCG levels.
