Summary declarations
SOGC/GOC Clinical Guideline #408, January 2021
If pregnancy symptoms persist for 4 to 6 weeks after termination of pregnancy, evacuation of a nonviable pregnancy, or spontaneous abortion, serum or urine hCG assay may provide early diagnosis of a GTD if products of conception are not routinely sent for pathology examination (medium).
Differentiation of CHM, PHM and GTN by a pathologist specializing in gynecology allows for personalized follow-up and management of GTN (low).
Treatment of hydatidiform mole consists of surgical evacuation by curettage and aspiration or hysterectomy with subsequent monitoring of human chorionic gonadotropin (average).
Prophylactic chemotherapy is considered only in high-risk patients who are unlikely to return for regular follow-up (very low).
Post-molar follow-up mainly consists of serial monitoring of the level of human chorionic gonadotropin (high).
It is possible to safely prescribe a method of hormonal contraception and insert an IUD after the normalization of the level of human chorionic gonadotropin (low).
Women with recurrent trophoblastic gestational disease should be referred to a genetic counseling service and genetic tests should be organised, as this is a rare situation which may be associated with a family genetic mutation (average ).
Findings of persistently low hCG can be benign (eg, false positive or pituitary hCG production), premalignant (eg, quiescent GTD), or malignant (eg, PSTT or ETT) (mean).
Long-term follow-up may ultimately reveal a diagnosis of GTN in patients with a true positive hCG result without immediate evidence of disease at the time of testing (low).
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