Monitoring
In the absence of histopathology, post-treatment measurement of human chorionic gonadotrophin (hCG) levels should be performed weekly until normalisation of hCG levels or diagnosis of gestational trophoblastic neoplasia (GTN). The duration of monitoring varies by country.[3] The International Federation of Gynecology and Obstetrics recommends monitoring hCG every 1-2 weeks post-treatment until levels return to normal, followed by a single confirmatory normal measurement within a month for partial hydatidiform moles and monthly hCG measurements for 6 months for complete hydatidiform moles.[4][41] In the UK, the Royal College of Obstetricians & Gynaecologists (RCOG) recommends monitoring hCG levels post-treatment until there are two normal measurements at least 4 weeks apart for partial hydatidiform moles. For complete hydatidiform moles, RCOG recommends monitoring hCG levels every month for 6 months either post-treatment if normalisation took up to 56 days or from the date of normalisation if this took more than 56 days.[34]
Close follow-up aims to maximise the detection of post-molar GTN by identifying plateaued or newly rising hCG levels.
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