How Long Should Patients Be Followed After Molar Pregnancy? Analysis of Serum hCG Follow-Up Data

Abstract

This randomized retrospective study was conducted to determine the length of follow up necessary after attainment of undetectable β-hCG levels after treatment of molar pregnancy. One hundred fifty patients were randomly selected from the registration list of more than 500 women who had been treated for complete or partial hydatidiform mole at the Hungarian National Health Center. Clinical and demographic data from the patients' charts were recorded for analysis. The mean age of the patients was 28.8 years (range, 15–51 years). The mean time to undetectable β-hCG levels was 9.7 weeks for the 94 patients diagnosed with complete mole and 6.5 weeks for the 56 patients with partial mole (<0.01). In 126 patients, the serum β-hCG levels returned to normal after molar evacuation with no further treatment. The remaining 24 underwent chemotherapy for persistent trophoblastic disease, including 22 with complete mole and 2 with partial mole. Women who developed persistent trophoblastic disease before β-hCG became undetectable were excluded from further analysis. The remaining 126 patients included 72 with complete mole and 54 with partial mole. Of 54 patients who failed to complete the study, 48 did so after achieving undetectable weekly serum β-hCG levels. Thus, there were 120 patients who achieved at least one undetectable serum β-hCG level and none had any evidence of recurrence of their disease.