After surgery or drug treatment for molar pregnancy you have regular follow up appointments and tests.
Blood and urine tests
You have urine tests or blood tests (or both) every 2 weeks. These tests check the level of a hormone called hCG. hCG means human chorionic gonadotrophic hormone.
The specialist hospital gives you a kit to collect your urine samples at home and you send the samples to them. If you are having blood tests, you have them at your GP surgery or local hospital.
The length of time you need to send samples for during follow up depends on your hCG levels and how quickly they go back to normal.
After a partial molar pregnancy
Once your hCG level is normal you give a further urine sample 4 weeks later. If your pathology has been reviewed at the hospital, your follow up is then complete. If the partial mole hasn't been confirmed by the pathologists, you have follow up as for a complete molar pregnancy.
After a complete molar pregnancy
If your hCG level is normal within 8 weeks, you have follow up for 6 months after your surgery. If your hCG levels come down more slowly than this, you continue with follow up until 6 months after your first normal hCG level.
If the hCG level doesn't go down
In a small number of women the hCG levels in the blood stay high after treatment. It is a sign that some abnormal cells are still present.
This is called persistent trophoblastic disease.
It happens in about 10 to 15 out of every 100 women who have had a complete molar pregnancy (10 to 15%).
It happens in about 1 in 100 women (1%) after a partial molar pregnancy.
If the hCG levels don't go down you need treatment with chemotherapy.
If you need to have chemotherapy, you go to one of the following hospitals:
- Weston Park Hospital in Sheffield
- Charing Cross Hospital in London
After a molar pregnancy it is important not to get pregnant again until your doctors say it is safe for you to try. It is fine to use oral contraceptives.
If you do become pregnant before your doctors recommend it, you must let your specialist team know. This is because your hCG levels 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.
You have appointments at the hospital every few months to check how you are and see whether you have any problems or worries. The appointments also give you the chance to raise any concerns or worries that you have.
Your doctor or nurse examines you at each appointment. They ask how you are feeling, whether you have had any symptoms or side effects and if you are worried about anything.
If you are worried
Many people find their tests and check ups quite worrying. A hospital appointment can bring back any anxiety or distress about your molar pregnancy.
It can help to tell someone close to you how you’re feeling. Sharing your worries can mean they don’t seem so overwhelming. Many people find it helpful to have counselling during and after their treatment.