Women should be advised not to conceive again until post-treatment follow-up is complete.[3]Horowitz NS, Eskander RN, Adelman MR, et al. Epidemiology, diagnosis, and treatment of gestational trophoblastic disease: A Society of Gynecologic Oncology evidenced-based review and recommendation. Gynecol Oncol. 2021 Dec;163(3):605-13.
https://www.gynecologiconcology-online.net/article/S0090-8258(21)01421-9/fulltext
http://www.ncbi.nlm.nih.gov/pubmed/34686354?tool=bestpractice.com
[34]Tidy, J, Seckl, M, Hancock, BW, on behalf of the Royal College of Obstetricians and Gynaecologists. Management of gestational trophoblastic disease. BJOG 2021;128: e1-e27.
https://obgyn.onlinelibrary.wiley.com/doi/full/10.1111/1471-0528.16266
[54]Faculty of Sexual & Reproductive Healthcare. FSRH GL on contraception after pregnancy. Jan 2017 [internet publication].
https://www.fsrh.org/standards-and-guidance/documents/contraception-after-pregnancy-executive-summary-document
Women who previously underwent chemotherapy for GTN should be advised not to conceive for 1 year after completion of treatment.[34]Tidy, J, Seckl, M, Hancock, BW, on behalf of the Royal College of Obstetricians and Gynaecologists. Management of gestational trophoblastic disease. BJOG 2021;128: e1-e27.
https://obgyn.onlinelibrary.wiley.com/doi/full/10.1111/1471-0528.16266
[54]Faculty of Sexual & Reproductive Healthcare. FSRH GL on contraception after pregnancy. Jan 2017 [internet publication].
https://www.fsrh.org/standards-and-guidance/documents/contraception-after-pregnancy-executive-summary-document
Subsequent pregnancies in women with prior gestational trophoblastic disease should be evaluated with early sonographic determination of a normal intrauterine gestation.[3]Horowitz NS, Eskander RN, Adelman MR, et al. Epidemiology, diagnosis, and treatment of gestational trophoblastic disease: A Society of Gynecologic Oncology evidenced-based review and recommendation. Gynecol Oncol. 2021 Dec;163(3):605-13.
https://www.gynecologiconcology-online.net/article/S0090-8258(21)01421-9/fulltext
http://www.ncbi.nlm.nih.gov/pubmed/34686354?tool=bestpractice.com
Although controversial, sending material obtained at the end of pregnancy (from an abortion, ectopic pregnancy, or placenta from a preterm/term pregnancy) may be appropriate to exclude cases of repeat GTD. If this is not possible, hCG levels can be measured 6-8 weeks after the end of the pregnancy to detect this serious condition early.[3]Horowitz NS, Eskander RN, Adelman MR, et al. Epidemiology, diagnosis, and treatment of gestational trophoblastic disease: A Society of Gynecologic Oncology evidenced-based review and recommendation. Gynecol Oncol. 2021 Dec;163(3):605-13.
https://www.gynecologiconcology-online.net/article/S0090-8258(21)01421-9/fulltext
http://www.ncbi.nlm.nih.gov/pubmed/34686354?tool=bestpractice.com