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Molar pregnancy (GTD)
Complete vs partial mole, evacuation and hCG follow-up.
Source: RCOG GTG 38 (2020)Types
| Complete | Diploid, all paternal DNA, no fetal tissue, p57 negative; 13–16% need chemotherapy. |
|---|---|
| Partial | Usually triploid, fetal tissue present; 0.5–1% need chemotherapy. |
Management
- Suction evacuation whatever the size; avoid medical evacuation for complete mole
- No oxytocin before evacuation complete unless life-threatening bleeding
- Anti-D after evacuation if Rh-negative
- Register with a GTD centre
hCG follow-up
| Complete | Normal within 56 days: follow up 6 months from evacuation; otherwise 6 months from normal. |
|---|---|
| Partial | Stop after normal hCG on 2 samples ≥4 weeks apart. |
WHO score ≤6 low risk (methotrexate); ≥7 high risk (EMA/CO). See FIGO staging → GTN.
A summary for trained clinicians. Always check the full guideline, the patient in front of you and your hospital's protocol. Spotted an error? Tell us.