Following suction evacuation of a hydatidiform mole, which contraceptive advice is correct for a woman during beta-hCG surveillance?
- A Combined oral contraceptive pills may be used and do not increase the risk of persistent gestational trophoblastic neoplasia ✓
- B Only barrier methods should be used until hCG becomes undetectable
- C All hormonal contraception should be avoided because it accelerates malignant transformation
- D An intrauterine device should be inserted immediately at evacuation
Correct answer: A. Combined oral contraceptive pills may be used and do not increase the risk of persistent gestational trophoblastic neoplasia
Explanation
Effective contraception is advised for the whole period of hCG follow-up, at least 6 months after levels normalise, because an intercurrent pregnancy would confound surveillance. The old concern that combined oral contraceptives increase the risk of persistent trophoblastic disease has been disproven, and they are recommended by FIGO. An IUD is avoided until hCG is normal or nearly normal because of the small uterus and bleeding risk after evacuation.
Reference: Williams Obstetrics, 26th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
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