Final answer:
Postoperative management of molar pregnancy includes monitoring hCG levels until undetectable, ensuring complete removal of molar tissue to prevent gestational trophoblastic disease, and encouraging breastfeeding to promote uterine involution. Future fertility options may be discussed, including in vitro fertilization or surgical interventions.
Step-by-step explanation:
The postoperative management of a molar pregnancy involves careful monitoring and follow-up due to the risk of persistent gestational trophoblastic disease (GTD). After the surgical treatment of a molar pregnancy, usually a dilation and curettage (D&C), the patient's serum human chorionic gonadotropin (hCG) levels are closely monitored to ensure they return to undetectable levels, indicating that all molar tissue has been removed and there is no residual GTD.
Continued monitoring of hCG levels is critical, as a rise could suggest persistent GTD or the development of gestational trophoblastic neoplasia, which may require further treatment such as chemotherapy. In addition, the obstetrician must ensure that the uterus is returning to its pre-pregnancy state, a process known as involution. This can be facilitated by breastfeeding, which helps in shrinking the uterus and minimizing the risk of postpartum hemorrhage by expelling any remaining fragments of the placenta.
For future pregnancies, options such as in vitro fertilization (IVF) might be discussed with patients who have a recurrence risk or other fertility concerns. Surgical procedures like re-ligation of the fallopian tubes or their removal may also be considered based on the individual's circumstances.