Women with a hydatidiform mole have an excellent prognosis. Women with a malignant form of<unk>  usually have a very good prognosis. Choriocarcinoma, for example, is an uncommon, yet almost always curable cancer. Although choriocarcinoma is a highly malignant tumour and a life-threatening<unk> , it is very sensitive to chemotherapy. Virtually all women with non-metastatic<unk>  are cured and retain their fertility; the prognosis is also very good for those with metastatic (spreading) cancer, in the early stages, but fertility may be lost. Hysterectomy (surgical removal of the uterus) can also be offered to patients > 40 years of age or those for whom sterilisation is not an obstacle. Only a few women with<unk>  have a poor prognosis, e.g. some forms of stage IV GTN. The FIGO staging system is used. The risk can be estimated by scoring systems such as the Modified WHO Prognostic Scoring System, wherein scores between 1 and 4 from various parameters are summed together: +Modified WHO Prognostic Scoring System 0 1 2 4 Age 12 Pretreatment serum hCG (IU/L) 3 103–104 104–105 >105 Largest tumor size (including uterus) 8 Previous failed chemotherapy – – single drug ≥2 drugs In this scoring system, women with a score of 7 or greater are considered at high risk. It is very important for malignant forms of<unk>  to be discovered in time. In Western countries, women with molar pregnancies are followed carefully; for instance, in the UK, all women who have had a molar pregnancy are registered at the National<unk>  Screening Centre. There are efforts in this direction in the developing countries too, and there have been improvements in these countries in the early detection of choriocarcinoma, thereby significantly reducing the mortality rate also in developing countries. Becoming pregnant again Most women with<unk>  can become pregnant again and can have children again. The risk of a further molar pregnancy is low. More than 98% of women who become pregnant following a molar pregnancy will not have a further hydatidiform mole or be at increased risk of complications. In the past, it was seen as important not to get pregnant straight away after a<unk> . Specialists recommended a waiting period of 6 months after the hCG levels become normal. Recently, this standpoint has been questioned. New medical data suggest that a significantly shorter waiting period after the hCG levels become normal is reasonable for approximately 97% of the patients with hydatidiform mole. Risk of a repeat<unk>  The risk of a repeat<unk>  is approximately 1 in 100, compared with approximately 1 in 1000 risk in the general population. Especially women whose hCG levels remain significantly elevated are at risk of developing a repeat<unk> . Persistent<unk><unk>  The term «persistent<unk><unk> » (PTD) is used when after treatment of a molar pregnancy, some molar tissue is left behind and again starts growing into a tumour. Although PTD can spread within the body like a malignant cancer, the overall cure rate is nearly 100%. In the vast majority of patients, treatment of PTD consist of chemotherapy. Only about 10% of patients with PTD can be treated successfully with a second curettage.<unk>  coexisting with a normal fetus, also called "twin pregnancy" In some very rare cases, a<unk>  can coexist with a normal fetus. This is called a "twin pregnancy". These cases should be managed only by experienced clinics, after extensive consultation with the patient. Because successful term delivery might be possible, the pregnancy should be allowed to proceed if the mother wishes, following appropriate counselling. The probability of achieving a healthy baby is approximately 40%, but there is a risk of complications, e.g. pulmonary embolism and pre-eclampsia. Compared with women who simply had a<unk>  in the past, there is no increased risk of developing persistent<unk>  after such a twin pregnancy. In few cases, a<unk>  had coexisted with a normal pregnancy, but this was discovered only incidentally after a normal birth.
Gestational trophoblastic disease
Forced pregnancy
Toxic abortion
Postpartum infections
Early pregnancy bleeding
After-birth abortion
Molar pregnancy
Puppy pregnancy syndrome