Following evacuation of a complete hydatidiform mole, a 24-year-old woman's serum beta-hCG becomes undetectable after 14 weeks of surveillance. She asks when she can safely discontinue reliable contraception. What is the standard recommendation?

• A Contraception may stop immediately once hCG is undetectable
• B Continue reliable contraception for 5 years after hCG normalisation
• C Continue reliable contraception for at least 6 months after hCG normalisation ✓
• D Contraception is unnecessary as hCG normalisation indicates cure

Explanation

After hCG normalises following molar evacuation, follow-up continues for 6 months because most cases of gestational trophoblastic neoplasia declare themselves within this window. Reliable contraception throughout prevents a new pregnancy from producing rising hCG that would be indistinguishable from recurrent disease and force interruption of surveillance. Women who develop high-risk GTN requiring chemotherapy are advised to wait 12 months after completion of treatment before conceiving, not 5 years.

Reference: Williams Obstetrics, 26th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.