A 24-year-old woman undergoes suction evacuation for a complete hydatidiform mole and asks about contraception during beta-hCG follow-up. She is in a stable monogamous relationship and wants effective contraception immediately. What should be advised?

• A Avoid all hormonal contraception until hCG is normal
• B Intrauterine contraceptive device insertion at evacuation, no other method
• C Only barrier methods are permitted during follow-up
• D Combined oral contraceptive pills are safe and may be started now ✓

Explanation

Large studies have shown that combined oral contraceptives do not increase the risk of post-molar gestational trophoblastic neoplasia and do not alter hCG regression curves, so they are recommended for reliable contraception during follow-up. Effective contraception matters mainly to prevent a new pregnancy from confusing hCG interpretation. An IUD should not be inserted immediately after molar evacuation because of the risk of perforation by the enlarged, softened uterus, and it offers no advantage over hormonal methods here.

Reference: Williams Obstetrics, 26th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.