Treatment for recurrent molar pregnancyá which is also called gestational trophoblastic neoplasia (GTN) usually consists of a chemotherapy medication methotrexate. It is fortunate enough, that methotrexate is considered to be quite an “easy” chemotherapy among others possible, and it is able to be given as an intramuscular shot. In the lightest cases only one shot may be enough, however, there are severe cases, when multiple shots of methotrexate, or cases, in which it is to be given in combination with some other medications.

In addition, if gestational trophoblastic neoplasia is suspected, the woman is usually to undergo a CT scan of her brain, lungs, and she is to make a number of blood tests. There exist two types of GTN: metastatic and nonmetastatic. In case of nonmetastatic GTN, the treatment may consist only of single agent chemotherapy or of hysterectomy; however, if a woman suffers from metastatic GTN, then the division into good prognosis and poor prognosis disease exists. As a rule in this case multi – agent chemotherapy is necessary for a woman to undergo. Therefore, those women, who belong to high risk groups as well as those, belonging to poor prognosis groups, require aggressive multi – drug regimens. It should also be noted, that any resistant area, which is possible to be irradiated, is irradiated, any involved organ or part of organ, which can possibly be removed, is removed with the help of a surgery, simply because in case if B – hCG level does not get down to normal and stay constant, the woman is more likely to die. All women, belonging to poor prognosis groups, are to be cured at a center, which is well – experienced in dealing with and treating this disease. All of them require extensive therapy to be conducted and support. They need vigorous and even ruthless treatment to be conducted. It is necessary to realize, that gestational trophoblastic neoplasia is a cancer, which can be cured, even in case if it is widely metastatic, and there is still a chance to survive even at the poorest prognosis.

The prognosis is usually dependant on the aggressiveness of treatment, conducted, as well as on the extent of this disease. When there is a proper management of a molar pregnancy, the chance to recover completely makes about 100%. In case of a non metastatic gestational trophoblastic neoplasia is vigorously treated, the cure rate is also as high as about 100%. In case if a widely metastatic GTN is recognized in a prompt way, and if it is treated aggressively with multi – agent chemotherapy, surgery and radiation, if there is a necessity, the chance to recover completely is about 80%. All the way during the treatment is conducted, there is a necessity to make hCG tests weekly until they fall to zero, after which careful follow 0 up is to be undertaken for as long as a year.

After a molar pregnancy has been evacuated, it is extremely important for a woman to see her doctor frequently, because there is the risk of its recurring. Generally follow – up includes a baseline chest X – ray, review of the pathology specimen, and physical examination of the vagina and uterus every couple of weeks up until the uterus becomes normal again and every three month for about as long as one year. Contraception is also included into the list of follow – up instructions, because a woman must not get pregnant again during the first year after the molar pregnancy was removed. And, of course, the most important part of these checking and measures of precaution is considered to be a hCG level blood test, which is to be conducted once a month for as long as one year. It is difficult not to notice, that all these measures involve quite often visits to the lab and the doctor’s office, however, it is extremely important, because every woman, who experienced a molar pregnancy is to be aware, that it is quite possible to “come back”, and in about 20% of cases it does reoccur, even after a thorough D&C procedure.