Postmolar trophoblastic disease in women using hormonal contraception with and without estrogen

One hundred thirteen patients with a molar pregnancy evacuated from January 5, 1976, through February 15, 1980, had close follow-up at the Los Angeles County-University of Southern California Women's Hospital. Twenty-seven patients (23.9%) developed postmolar trophoblastic disease, all of whom achieved remission with treatment. Of the 113 patients, 71 (62.8%) used only oral contraceptives, 32 patients (28.3%) used only intramuscular medroxyprogesterone acetate, seven patients (6.2%) used both oral contraceptives and medroxyprogesterone acetate, and three patients (2.7%) used nonhormonal contraception after evacuation of their molar pregnancy and before titer remission. Analysis of significant clinical and laboratory correlates of postmolar trophoblastic disease for the study group revealed no substantial bias in assignment of contraceptive method. There was no significant difference between the oral contraceptive and the medroxyprogesterone acetate groups with respect to the development of postmolar trophoblastic disease or the time to spontaneous titer remission. The study shows no apparent adverse effect of the estrogen (50 mg mestranol) component in oral contraceptives on the frequency of postmolar trophoblastic disease.