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Follow up after molar pregnancy

Men and women discussing gestational trophoblastic tumours

This page tells you about follow up after having treatment for molar pregnancy. There is information below about

 

A quick guide to what's on this page

Follow up after molar pregnancy

If you have had a molar pregnancy, your doctor will follow your progress closely. They will check that all the abnormal cells have gone and look for any signs of them coming back. They will refer you to one of 3 specialist centres in the UK for follow up.

What follow up involves

You will have urine or blood tests to check your hCG levels. The specialist centre will give you a kit for your urine tests and you send the samples to them. If you are having blood tests, your GP surgery may be able to do them.

If you’ve had a D and C you’ll need tests every 2 weeks to check your hCG levels. Once your levels are normal the tests will become less frequent. You will have follow up for at least 6 months. The length of follow up will depend on your hCG levels and how quickly they fall to normal levels. 

Future pregnancy

It is important not to get pregnant until your doctors say that it is safe to try. But if you do become pregnant before they recommend it, you must let your specialist team know. This is because your hCG levels will go up with a normal pregnancy, so they won’t be able to monitor your disease using your hCG levels. After you have had your baby, you will need to have further hCG tests.

 

CR PDF Icon You can view and print the quick guides for all the pages in the treating molar pregnancy section.

 

 

Why you need follow up

A molar pregnancy occurs when the fertilisation of the egg by the sperm goes wrong and leads to the growth of abnormal cells or clusters of water filled sacs inside the womb. This condition is one of a group of conditions known as gestational trophoblastic tumours (GTT for short).

If you have had a molar pregnancy, your doctors will follow your progress closely. They check that all the molar tissue has gone and look for any signs of it coming back.

All women in the UK diagnosed with a molar pregnancy are referred to, and registered at, one of 3 specialist hospitals for their follow up. These centres are at

  • Charing Cross Hospital in London
  • Weston Park Hospital in Sheffield
  • Ninewells Hospital in Dundee

The length of your follow up will depend on how quickly the blood level of a hormone called hCG falls and whether you need further treatment.

 

What follow up for molar pregnancy involves

You will have urine or blood tests to check your hCG level (human chorionic gonadotrophic hormone). The specialist hospital will give you a kit for your urine tests and you send the samples to them. If you are having blood tests, your GP surgery may be able to do them for you.

If you’ve had a D and C you’ll have urine or blood tests or both, every 2 weeks. The length of time you will need to send samples for during follow up depends on your hCG levels and how quickly they go back to normal. 

For a partial mole, once your hCG level is normal a further urine sample is requested 4 weeks later. If your pathology has been reviewed at the hospital, follow up will then be complete. If the partial mole has not been confirmed by the pathologists, you will have follow up as for a complete molar pregnancy. 

For a complete molar pregnancy if your hCG level is normal within 8 weeks, you will have follow up for 6 months from your surgery. If your hCG levels come down more slowly than this, you will continue with follow up until 6 months after your first normal hCG level. 

Your treatment centre will send you all the kits that you need for the follow up tests when you need to do them. So you don’t need to worry about remembering the timings yourself.

If the levels of hCG don't go down or start to go up, it is a sign that some abnormal cells are still present. This is called persistent trophoblastic disease. If you need to have chemotherapy treatment for persistent trophoblastic disease, you can look at our information about follow up after persistent trophoblastic disease and choriocarcinoma in this section.

 

Future pregnancy

It’s important not to get pregnant again until your doctors say it is safe for you to try. It is fine to use oral contraceptives. But if you do become pregnant before they recommend it, you must let your specialist team know. This is because your hCG levels will go up with a normal pregnancy, so they won’t be able to monitor you for the molar pregnancy by using your hCG levels. After you have had your baby, your doctor will check your hCG levels again.

Once you have finished follow up, your treatment team will tell you to contact your specialist hospital at the end of any future pregnancy. This is so that the staff can check your hCG level and make sure it has gone back to normal. They usually do this about 6 to 8 weeks after any pregnancy, including miscarriage.

Most women (more than 98%) who become pregnant after a molar pregnancy will not have another molar pregnancy. There is also no increased risk of complications in future pregnancies.

There is detailed information about contraception and future pregnancies in the living with molar pregnancy and choriocarcinoma section.

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Updated: 15 June 2016