What are the usual treatments for persistent trophoblast disease after a molar pregnancy?
There are three treatment possibilities for patients with persistent trophoblast disease after a molar pregnancy. The most frequent choice is to use chemotherapy treatment. This approach, whilst it sounds complicated, is usually very simple, generally has few side-effects, allows patients to retain their fertility and has a cure rate of over 99%. More details on the practicalities of chemotherapy are given in the section below. The second treatment option is to perform a second evacuation of the uterus with the aim of physically removing the residual disease. This can be curative in a minority of patients and help them avoid the need for chemotherapy treatment. Recent reviews from Sheffield, Charing Cross and Holland suggest that second evacuations are best reserved for patients with no evidence of disease spread, an abnormality on the ultrasound of the uterus and an hCG level no higher than 1,500-5,000iu/L. Currently we recommend that patients do not undergo a second evacuation if the
