Practice Changes

SOGC/GOC Clinical Guideline #408, January 2021

Perform serum hCG measurement in women of childbearing potential with abnormal uterine bleeding, including bleeding > 6 weeks post-pregnancy (i.e., after term or preterm delivery, extra -uterine, termination of pregnancy, evacuation of non-viable pregnancy or spontaneous abortion) or with signs of metastatic disease, in order to quickly diagnose and manage GTD.

After evacuation of a molar pregnancy, begin weekly hCG monitoring 2 weeks after the procedure and continue until the hCG level remains undetectable for 3 consecutive weeks. In case of CHM, continue monitoring hCG monthly for 6 months. In case of PHM, perform the hCG assay 1 month after the first result of undetectable hCG level to confirm resolution.

Discuss each GTN case at multidisciplinary oncology case meetings and enter it into a regional and/or centralized database.

2021. Guideline No. 408: Management of Gestational Trophoblastic Diseases. Eiriksson L, Dean E, Sebastianelli A, Salvador S, Comeau R, Jang JH, Bouchard-Fortier G, Osborne R, Sauthier Ph. J Obstet Gynaecol Can;43(1):91-105.

Modified on 12/22/2023