Understanding Post-Molar Pregnancy Bleeding: Causes & What to Expect

Question
Dear Dr. Kandeel,

I am 25yrs old, and have had two normal, full-term pregnancies. I was diagnosed as having had a molar pregnancy in late November 2009, I immediately had a D and C and my HCg levels were back to normal by the last week of December. I had bleeding for the full month of Dec (post D&C) that was heavy with lots of clots and bad cramping, but no infection was detected by my Dr.

Since the end of December, I have been having cycles of bleeding that last for 5-7 days with 10-14 days in between them. The bleeding has been heavy with lots of clots, and bad cramping. I saw a doctor in the ER who prescribed Naproxin to be used as needed for the cramps I was experiencing, but couldn't tell me anything else. I have had 2 Beta HCg Serum blood tests since my levels returned to 0, the latest yesterday, and my levels are still good.

I want to know if there is anything else I should do regarding the irregularity and severity of my bleeding, or if things will just "work themselves out".

Thank you.

Answer
Dear Robyn

Irregular menstruation for few weeks after evacuation of molar pregnancy is not unusual. However, after normalization of hCG level, cycle pattern should start to improve/normalize, as the hCG value itself takes few weeks to reach zero level.

Therefore I would suggest having a transvaginal sonogram to ensure the complete evacuation of your uterus and determining the hCG level in a different laboratory to make sure that results are accurate.

I wish you best of luck.