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Staging molar pregnancy

Men and women discussing gestational trophoblastic tumours

This page tells you about staging molar pregnancy. There is information about

 

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Staging molar pregnancy

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. Doctors use surgery to remove the abnormal cells. 

Staging is a system that doctors use to explain how far a disease has grown or spread. If all the abnormal molar tissue cells have been completely removed, your blood levels of a hormone called human chorionic gonadotrophin (hCG) levels go back to normal. Then your doctor won't need to give the molar pregnancy a stage. Apart from follow up blood and urine tests to check for any return of the abnormal cells, you won’t need any further tests to stage it. And you won’t need any further treatment.

Staging persistent gestational trophoblastic tumours

Most women will not need any further treatment for a molar pregnancy. But in some women some of the abnormal cells may remain after surgery and may spread into the deeper levels of the womb or to other parts of the body. This is called persistent trophoblastic disease. In this case you will need further tests to help stage your disease. The stage tells the doctor if the disease has spread, and if so, how far. Staging is important because it helps your doctor know which treatment is most suitable for you.

The staging system used for persistent trophoblastic disease is called the FIGO staging system. There is information about the FIGO system in the page about staging persistent trophoblastic disease and choriocarcinoma.

 

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Staging molar pregnancy

Molar pregnancy is a type of gestational trophoblastic tumour (GTT).

Staging is a system that doctors use to explain how far tumours have grown or spread. Doctors usually remove the abnormal molar pregnancy tissue from the womb. If the levels of a hormone called hCG go back to normal soon after removal of the molar pregnancy then your doctor won't need to give it a stage. 

In most women, the hCG level virtually disappears within 4 to 6 weeks of removing the molar pregnancy. Once the molar tissue has gone from the womb, it can’t produce hCG. So apart from follow up blood tests and urine tests to check for any return of the molar tissue, you won’t need any further tests to stage it. And you won’t need any further treatment. You can find information about follow up after molar pregnancy in this section.

 

Staging persistent gestational trophoblastic tumours (GTT)

Most women will not need any further treatment for a molar pregnancy. But in some women some abnormal cells may remain and may spread into the deeper layers of the womb or other parts of the body. Doctors call this persistent trophoblastic disease. The signs of this are

  • Your hCG level is raised, and not falling, for 3 tests (over a period of 3 weeks or longer)
  • Your hCG goes up on 2 measurements in a row, over a period of at least 2 weeks
  • Your hCG level is more than 20,000 IU/L (international units per litre) at more than 4 weeks after surgery
  • Your hCG level stays high for 6 months or longer, even if the level is coming down
  • Evidence of choriocarcinoma cells in the tissue removed from the womb
  • You have heavy vaginal bleeding and/or severe abdominal pain.

In this case you will need further tests to help stage the tumour. The stage tells the doctor if the gestational trophoblastic tumour has spread, and if so, how far. Staging is important because it helps your doctor know which treatment is most suitable for you.

The staging system used for persistent trophoblastic disease is called the FIGO staging system. This system looks at whether the abnormal cells have spread and it gives scores for various risk factors for your specialist to work out which type of treatment you need.

There is information about the FIGO staging of GTT in our persistent trophoblastic disease and choriocarcinoma section.

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Updated: 15 June 2016