February 26th, 2020

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Shortened Follow-up After Partial Molar Pregnancy: A Prospective Evaluation Based on Selective Histopathology Review
Authors:  Annie Hills, R.N., Kam Singh, R.N., Jane Ireson, R.N., Sarah Gillett, R.N., Matthew Winter, M.D., Barry Hancock, M.D., and John Tidy, M.D.
  OBJECTIVE: To assess whether a more selective follow-up of patients with partial hydatidiform mole could shorten their monitoring period. Change of United Kingdom practice in 2013 meant that women with partial molar pregnancy could be followed up for just 4 weeks of normal human chorionic gonadotropin, providing that the diagnosis was confirmed on central histology review.

STUDY DESIGN: Women over 30 and those who were markedly distressed or who had multiple pregnancy losses were prioritized, along with women who had had fertility treatment or repeat moles. There were 541 gestational trophoblastic disease registrations between September 1, 2013, and August 31, 2014; 290 of those were partial moles; histopathology was reviewed in 166.

RESULTS: Follow-up was more than halved (87 as opposed to 196 days) for reviewed patients, a large number of whom went on to conceive new pregnancies and deliver babies. A notable number of cases (45) were found to be nonmolar. There were no cases of gestational trophoblastic neoplasia (GTN).

CONCLUSION: The shortened follow-up provided a real benefit to the selected patients, who were able to try to conceive again much sooner than previously. Reassuringly, no GTN was found, and for 45 women there was excellent news in that they did not need further screening.
Keywords:  follow-up care; follow-up studies; gestational trophoblastic disease; HCG (human chorionic gonadotropin); histopathology review; human chorionic gonadotropin; hydatidiform mole; hydatidiform mole, partial; molar pregnancy
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