Post mole follow-up

SOGC/GOC Clinical Guideline #408, January 2021

Quantitative determination of total serum hCG should be performed using a commercially available test capable of detecting hCG levels < 5 mIU/ml as well as all forms of hCG, including the ß-hCG, the ß-core fragment, the C-terminal extension, the cleaved free ß subunit and the ß-core.
It is recommended to use the same test at each dosage during follow-up to avoid variation of results between laboratories (unnecessary tx, side effects and resistance).
A shorter follow-up period may be considered in patients with CHM who wish to become pregnant, particularly those ≥ 35 years old and especially those with a history of infertility.
The risk of GTN is < 1% after MHC or PHM once hCG reaches undetectable levels and this risk is lowest in patients whose normalization has been observed within the first 56 days .
IUDs should be avoided until normalization of serum hCG levels to reduce the risk of uterine perforation.

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