Completing Treatment and Follow-up

For patients that need treatment after the evacuation of a molar pregnancy the chemotherapy treatment usually continues for between 3 and 5 months. The exact duration of treatment is determined by the hCG level. Our policy at Charing Cross is to continue treatment until the hCG has reached normal (4 or less) and then to have a further 3 cycles (or 6 weeks) of treatment after this. The aim of this extra treatment is to kill off any remaining cells that may still be present, although the blood test has reached ‘normal’.

After the completion of chemotherapy treatment patients come back to clinic 6 weeks later for review. At this visit the ultrasound of the uterus and any other tests that were abnormal at the time of diagnosis are repeated. Usually these tests will all have returned to normal and no further treatment or investigations are required.

The advice we usually give is that the illness is most probably cured, that there is a small risk of relapse but that adhering to the hCG follow-up protocol is helpful in diagnosing earlier the rare cases of relapse.

The other important issues discussed are the advice to delay further pregnancy for around 12 months after the completion of therapy and that the risk of a further molar pregnancy is relatively low at approximately 1 in 100.

After completion of chemotherapy there are no restrictions on the type of contraception that can be used. Most women find that the chemotherapy stops their periods for a few months, but generally menstrual cycles restart 2-6 months after finishing treatment.

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