Post-GTN follow-up

SOGC/GOC Clinical Guideline #408, January 2021

  • At the end of the treatment, imaging examinations are carried out and serve as a basis for comparison.
  • Residual lesions are sometimes observable, particularly in the lungs, liver or CNS, but they do not require excision or further treatment if the hCG level remains undetectable.
  • The risk of recurrence is about 3%, usually within the first 12 months of follow-up.
  • Serum hCG levels are monitored weekly (4 to 6 wk) and then monthly for at least 12 to 24 months for low-risk and high-risk conditions, respectively.
  • Pregnancy should be prevented by using a reliable contraceptive method, ie hormonal contraception or the IUD, during the monitoring period.
  • Increased risk of adverse outcome for pregnancies conceived < 6 months after the end of chemotherapy:
  • Spontaneous abortion;
  • Recurrent mole;
  • Threat of premature delivery;
  • Pre-eclampsia and placental pathologies.
  • These risks seem to be lower in the event of a pregnancy conceived ≥ 1 year after the end of chemotherapy.

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 12/23/2023