Moles and pregnancies

SOGC/GOC Clinical Guideline #408, January 2021

GTD in case of multiple pregnancy

Affected patients (0.5% of GTDs) are at increased risk of pre-eclampsia, hemorrhage, thyrotoxicosis, preterm labor and subsequent GTN.
60% of pregnancies that continued resulted in live births. Progression to GTN was observed in 46% of patients (unaffected by termination of pregnancy).
There should be an informed discussion about the risks and benefits of continuing the pregnancy and, if the pregnancy continues, ensure joint management by a gynecological oncologist and a specialist in maternal-fetal medicine.

Pregnancy during GTD follow-up

As the serum hCG level is the primary marker used in GTD monitoring, pregnancy during the follow-up period poses a significant clinical challenge.
A management plan should be developed based on the patient's circumstances, preferences and risk of recurrence.

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