The following information is intended to explain to you the importance of monitoring and the treatments proposed to you by your doctor. You can listen to all the texts of the answers by clicking on the button: Listen to the text ▶︎
Trophoblastic gestational diseases include several diseases of the placenta. The main disease is called a mole. The frequency of moles is estimated at about 1 in 500 to 800 pregnancies. They are due to abnormalities in the fertilization of the egg by the sperm for an undetermined reason. The placenta then develops abnormally. There are 2 types of moles. It can be a "complete" mole in which there is no embryo or a "partial" mole in which the embryo develops but cannot survive. The placenta is abnormal in both cases.
Even when performed with care, after evacuation of the mole by curettage and aspiration, there is a risk of persistence of barely visible molar tissue in the uterus. This tissue can proliferate and spread, it is then called malignant trophoblastic gestational disease (or gestational trophoblastic neoplasia). This risk justifies monitoring by blood tests which are the regular dosage of the pregnancy hormone (βhCG). In 85% of patients, the hormone level returns to normal (negativation) without any problem within more or less 56 days. After evacuation of a molar pregnancy, you should begin weekly βhCG monitoring 2 weeks after the procedure and continue until the βhCG level remains undetectable for 3 consecutive weeks. In the event of a complete mole, you must continue monitoring βhCG monthly for 6 months after the negativation. In the event of a partial mole, you must carry out the βhCG assay 1 month after the first result of undetectable βhCG levels in order to confirm the negativation.
Taking the pill is strongly recommended (in the absence of a contraindication) immediately following the evacuation of the mole and for the entire βhCG monitoring period. The reason is that in the event of a new pregnancy, we would be unable to differentiate, at first, between a normal pregnancy and gestational trophoblastic neoplasia, because βhCG increases in both cases. Inserting an IUD can be considered but must be discussed with your gynecologist.
After the evacuation of the mole, you will bleed for a few days during which it is advisable not to use a tampon to avoid the risk of infection. Periods usually return within 4-6 weeks and then will be regular if you take the pill. The appearance of abnormal bleeding apart from the rules imposes that you speak about it to your doctor.
You can consider a new pregnancy as soon as the monitoring of the βhCG is finished, i.e. 6 months after their negativation for complete moles and as soon as you are discharged for partial moles. The risk of mole recurrence at this time is very low and estimated at around 0.5 to 1%. It is important to perform an ultrasound at the beginning of pregnancy to make sure that everything is going well and a βhCG assay 6 weeks after delivery to check that there is no recurrence. Careful examination of the placenta is also desirable.
Your entourage can sometimes give you, unwittingly, partially accurate or inaccurate information. The rarity of this disease means that it is often poorly understood. It is important to obtain information from your doctor, from doctors specialized in this field or from websites of teams used to treating these patients. You can contact us if you want advice or information about your surveillance. We also invite you to visit our links .
Modified on 12/24/2023