As mulheres devem ser orientadas a não conceber novamente até que o acompanhamento pós-tratamento seja concluído.[3]Horowitz NS, Eskander RN, Adelman MR, et al. Epidemiology, diagnosis, and treatment of gestational trophoblastic disease: A Society of Gynecologic Oncology evidenced-based review and recommendation. Gynecol Oncol. 2021 Dec;163(3):605-13.
https://www.gynecologiconcology-online.net/article/S0090-8258(21)01421-9/fulltext
http://www.ncbi.nlm.nih.gov/pubmed/34686354?tool=bestpractice.com
[34]Tidy, J, Seckl, M, Hancock, BW, on behalf of the Royal College of Obstetricians and Gynaecologists. Management of gestational trophoblastic disease. BJOG 2021;128: e1-e27.
https://obgyn.onlinelibrary.wiley.com/doi/full/10.1111/1471-0528.16266
[54]Faculty of Sexual & Reproductive Healthcare. FSRH GL on contraception after pregnancy. Jan 2017 [internet publication].
https://www.fsrh.org/standards-and-guidance/documents/contraception-after-pregnancy-executive-summary-document
Mulheres que foram previamente submetidas à quimioterapia para NTG devem ser orientadas a não conceber por 1 ano após a conclusão do tratamento.[34]Tidy, J, Seckl, M, Hancock, BW, on behalf of the Royal College of Obstetricians and Gynaecologists. Management of gestational trophoblastic disease. BJOG 2021;128: e1-e27.
https://obgyn.onlinelibrary.wiley.com/doi/full/10.1111/1471-0528.16266
[54]Faculty of Sexual & Reproductive Healthcare. FSRH GL on contraception after pregnancy. Jan 2017 [internet publication].
https://www.fsrh.org/standards-and-guidance/documents/contraception-after-pregnancy-executive-summary-document
As gestações subsequentes em mulheres com doença trofoblástica gestacional prévia devem ser avaliadas com determinação ultrassonográfica precoce de uma gestação intrauterina normal.[3]Horowitz NS, Eskander RN, Adelman MR, et al. Epidemiology, diagnosis, and treatment of gestational trophoblastic disease: A Society of Gynecologic Oncology evidenced-based review and recommendation. Gynecol Oncol. 2021 Dec;163(3):605-13.
https://www.gynecologiconcology-online.net/article/S0090-8258(21)01421-9/fulltext
http://www.ncbi.nlm.nih.gov/pubmed/34686354?tool=bestpractice.com
Embora controverso, o envio de material obtido no fim da gestação (de um aborto, gravidez ectópica ou placenta de uma gestação pré-termo/a termo) pode ser adequado para descartar casos de DTG repetida. Caso não seja possível, os níveis de hCG podem ser medidos 6-8 semanas após o fim da gestação para detectar essa doença grave de maneira precoce.[3]Horowitz NS, Eskander RN, Adelman MR, et al. Epidemiology, diagnosis, and treatment of gestational trophoblastic disease: A Society of Gynecologic Oncology evidenced-based review and recommendation. Gynecol Oncol. 2021 Dec;163(3):605-13.
https://www.gynecologiconcology-online.net/article/S0090-8258(21)01421-9/fulltext
http://www.ncbi.nlm.nih.gov/pubmed/34686354?tool=bestpractice.com