Drug treatment to remove molar pregnancy

After a diagnosis of molar pregnancy, the molar tissue needs removing from the womb. Some women who have a molar pregnancy have drug treatment. It makes the womb contract and remove the abnormal cells. This is called medical management or medical evacuation.

Before your treatment

Your nurse, doctor or midwife will explain the treatment to you. You can ask them any questions that you have. You are likely to feel upset and shocked. It can be hard to take in information. You can ask again if you need to. 

How you have the treatment

Your nurse or midwife gives you some tablets that you swallow. They also put a pessary (a large tablet) into the vagina, close to the entrance of the womb. This helps the entrance to the womb to open and allows the molar pregnancy tissue to pass out.

It normally takes a few hours for the medicines to work. You will have cramps in your abdomen (tummy) and some vaginal bleeding. It can take up to a few hours for the whole molar pregnancy to pass. You will have painkillers.

The tissue you pass is sent to the laboratory for checking.

Your healthcare team can talk through what will happen and tell you when you can go home.

After the treatment

You might be able to go home the same day or you might need to stay in hospital overnight. You have some bleeding for up to 3 weeks afterwards. If the bleeding doesn’t stop or gets very heavy you should go back to the hospital straight away.

How you might feel

It’s not easy to deal with a molar pregnancy and you might have very strong emotions that feel overwhelming. Your healthcare team will support you and offer some options for counselling and support.

Follow up tests after your treatment

For most women, the treatment removes most of the molar tissue and any remaining cells die off on their own. So you don't need more treatment. But sometimes a few cells can remain in the womb and carry on growing.

You need to have regular follow up to make sure you have no signs of remaining molar tissue.

Follow up means regular blood or urine tests to check the levels of a hormone called hCG in your blood and urine. If the levels stay high or they go up, you might need to have surgery or chemotherapy treatment.

About 1 out of every 100 women (1%) with a partial molar pregnancy will need chemotherapy.

About 13 to 16 out of every 100 women (13 to 16%) who have a complete molar pregnancy will need treatment with chemotherapy.