Diagnosis
An ultrasound scan may indicate that a complete molar pregnancy (CHM) is present and you will be admitted to hospital for a surgical procedure called an ERPC – evacuation of the retained products of conception. This procedure is necessary to remove the molar tissue. This is because there is a risk that the molar tissue will continue to grow and cause heavier bleeding. There is also a small chance that the molar tissue could spread outside the womb. A definitive diagnosis is not made until the tissue has been examined in the laboratory.
For partial molar pregnancies it is unusual that the diagnosis is suspected on ultrasound scan and although you may have presented to hospital with bleeding you may have been diagnosed with a threatened or inevitable miscarriage and offered medical or surgical management of your miscarriage. The miscarriage tissue (if available) will always be sent to the laboratory for examination and it is only on laboratory examination that a diagnosis of a partial molar pregnancy is confirmed. Therefore, you will not know leaving the hospital that you may have a diagnosis of partial molar pregnancy and will only know when you are contacted and asked to return to the hospital for a blood test to check for the pregnancy hormone called Human chorionic gonadotropin (calledhCG)
If you are diagnosed with a complete or partial mole, it is imperative that you do not become pregnant during your follow up. Therefore, your doctor at the hospital should discuss adequate contraception with you. Contraception should be used from diagnosis until follow up is complete. (Please see Patient Information Leaflet)
Complete Mole hCG Follow Up
As you are aware you will be required to have a weekly blood test to check on the levels of hCG or pregnancy hormone. We expect that these blood levels will continue to drop until they reach normal levels. For patients with complete moles the levels usually start off quite high and may take up to 12 weeks to become normal. Once the levels are normal for three weeks in a row you will then have a monthly level checked for 6 months. Then follow up is complete. In 12-15% patients the hCG levels fail to fall appropriately or may even rise during follow up and this is an indication that some treatment will be required to ensure the hCG levels fall to normal.
Partial Mole hCG Follow Up
As you are aware you will be required to have a weekly blood test to check on the levels of hCG or pregnancy hormone. We expect that these blood levels will continue to drop until they reach normal levels. For patients with partial moles the hCG levels usually fall very quickly and are often normal about 6 weeks after diagnosis. Once the hCg level has reached normal we ask for one further hCG level one month later. Then follow up is complete. In 1-2% patients the hCG levels fail to fall appropriately or may even rise during follow up and this is an indication that some treatment will be required to ensure the hCG levels fall to normal.
