Follow up after a molar pregnancy

After surgery or drug treatment for molar pregnancy you have regular follow up appointments and tests.

Because molar pregnancy is very rare, a specialist centre will monitor you. There are 3 specialist centres in the UK. These are:

• Charing Cross Hospital in London
• Weston Park Hospital in Sheffield
• Ninewells Hospital in Dundee

You might not have to go to the specialist centre, but they will be in charge of your care.

Blood and urine tests

After your treatment, any molar cells that are left usually die off by themselves. But sometimes they will keep growing.

Molar cells produce a hormone called hCG (human chorionic gonadotrophic hormone). You have urine tests or blood tests (or both) every 2 weeks to check your level of hCG. The level should go down after your treatment.  Sometimes this can take a few weeks, or it might take a few months.

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:

• the type of molar pregnancy 
• your hCG levels 
• how quickly your hCG level goes back to normal 

If the type of molar pregnancy wasn’t confirmed by the hospital laboratory, you will have follow up for a complete molar pregnancy.

After a partial molar pregnancy

Once your hCG level is normal you give a final blood or urine sample 4 weeks later.  

After a complete molar pregnancy

If your hCG level is normal within 8 weeks, you have follow up for 6 months after your treatment. If your hCG levels take more than 8 weeks to come down, 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 or go back up after treatment. It is a sign that some abnormal cells are still present.

This is called an invasive mole or persistent trophoblastic disease (PTD).

It happens in about 13 to 16 out of every 100 women who have had a complete molar pregnancy (13 to 16%).

It happens in about 1 in 100 women (1%) after a partial molar pregnancy.

If your 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

Pregnancy during the follow up period

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 straight away. This is because your hCG levels go up with a normal pregnancy. So they won’t be able to monitor the molar pregnancy by using your hCG levels. After you have had your baby, your doctor will check your hCG levels again.

Future pregnancy

Most women (around 99%) 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 might be asked to contact your specialist hospital at the end of any future pregnancy. Your specialist team will discuss this with you.

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.