Patient's question:
Medical Description: On July 23rd, I went to the hospital for a check-up for a missed miscarriage (dead molar pregnancy) and had a D&C (dilation and curettage) the same day. On July 30th, I went for a follow-up ultrasound, which showed a dark band, unsure if it was residual tissue or blood, so a second D&C was necessary. The D&C revealed only blood inside. The CHG level was 2160 on that day. On August 6th, I went for another ultrasound, which showed clotted blood, so a third D&C was performed. The CHG level was 335.3 on that day. Today, I went to the hospital for a follow-up ultrasound, which showed some clotted blood, less than before, but it still exists. I don’t want to have another D&C anymore. I’m afraid it will affect my future fertility.Past Medical History and Treatment: CHG levels have significantly decreased, and the urine test is negative. Now, the issue is that the clotted blood inside won’t discharge.
Help Needed: How can I ensure the clotted blood is completely removed from the uterus?
Doctor's answer:
Human chorionic gonadotropin (hCG) is a tumor marker for gestational trophoblastic disease. After the patient clears the molar pregnancy, blood tests are conducted every two weeks to monitor whether the hCG levels gradually decline to normal and remain stable. Once this condition is met, the frequency of testing can be reduced to monthly. Continuous monitoring is maintained for six months, after which the interval can be extended to every two months until the one-year mark. If no recurrence occurs within the year, it is considered cured.If you are diagnosed with a molar pregnancy, a dilatation and curettage (D&C) or suction evacuation procedure is typically performed to remove the abnormal tissue. The surgery is usually conducted under general anesthesia or local anesthesia, and you may also choose intravenous sedation.