Use of reliable hormonal contraception is recommended
while hCG values are being monitored. Oral contraceptives
do not increase the incidence of postmolar
gestational trophoblastic disease or alter the pattern of
regression of hCG values (13). Frequent pelvic examinations
are performed while hCG values are elevated
to monitor the involution of pelvic structures and to aid
in the early identification of vaginal metastases. Although
pregnancies after molar evacuation usually are
normal gestations, pregnancy obscures the value of
monitoring hCG levels during this interval and may result
in a delayed diagnosis of postmolar malignant gestational
trophoblastic disease.