Staging molar pregnancy

Molar pregnancy is a type of gestational trophoblastic tumour (GTT). We have a section about GTT which gives information about these tumours.

Staging is a system that doctors use to explain how far tumours have grown or spread. If your hCG levels go back to normal soon after removal of the molar pregnancy then your doctor won't need to give it a stage. In most women, the hCG level virtually disappears within 4 to 6 weeks of removing the molar pregnancy. Once the molar tissue has gone from the womb, it can’t produce hCG. So apart from follow up blood and urine tests to check for any return of the molar tissue, you won’t need any further tests to stage it. And you won’t need any further treatment. You can find more information about follow up after molar pregnancy in this section.

Most women will not need any further treatment for a molar pregnancy. But some women may show signs of persistent trophoblastic disease. The signs of this are

• Your hCG level is raised for 4 tests, over a period of 3 weeks or longer
• Your hCG goes up on 2 measurements in a row, over a period of at least 2 weeks
• Your hCG level is 20,000 IU/L (international units per litre) or more, 4 weeks after surgery
• Your hCG level stays high for 6 months or longer, even if the level is coming down
• Evidence of choriocarcinoma cells in the tissue removed from the womb

In this case you will need further tests to help stage your GTT. The stage tells the doctor if the GTT has spread, and if so, how far. Staging is important because it helps your doctor know which treatment is most suitable for you.

The staging system used for persistent trophoblastic disease is called the FIGO staging system. This system looks at whether the abnormal cells have spread and it gives scores for various risk factors for your specialist to work out which type of treatment you need.

There is more information about the FIGO staging of GTT in our persistent trophoblastic disease and choriocarcinoma section.