A 22-year-old woman undergoes suction evacuation for complete hydatidiform mole. Regarding contraception during post-molar surveillance, which recommendation is most appropriate?
- A Combined oral contraceptive pills can be started immediately after evacuation
- B Reliable contraception (combined oral contraceptives acceptable) is recommended throughout the surveillance period until hCG is normal ✓
- D Intrauterine device should be inserted at 6 weeks post-evacuation to prevent future moles
- C Barrier contraception should be used exclusively for 12 months
Correct answer: B. Reliable contraception (combined oral contraceptives acceptable) is recommended throughout the surveillance period until hCG is normal
Explanation
Reliable contraception is recommended throughout the post-molar surveillance period to avoid confusion between rising hCG from a new pregnancy and GTN. Contrary to older teaching, combined oral contraceptive pills do not increase the risk of GTN and are safe to use after evacuation. An IUD should not be inserted until hCG is normalized due to uterine perforation risk.
Reference: ACOG Practice Bulletin: Gestational Trophoblastic Disease, 2022 ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.