RCT on the Efficacy of Methotrexate for the Prevention of GTD

Inclusion Criteria: * diagnosis and molar evacuation done at the Department of Obstetrics and Gynecology of the Philippine General Hospital; * patients who will undergo suction curettage for evacuation of molar pregnancy; * histopathologically confirmed complete hydatidiform mole; * must have at least one of the following risk factors for the development of postmolar gestational trophoblastic disease: * uterine size larger than age of gestation of more than 6 weeks * serum B-hCG titer more than or equal to 100,000 mlU/ml * theca lutein cysts more than or equal to 6 cms in size * gravidity of 4 or more * recurrent molar pregnancy * medical complications arising from trophoblastic proliferation such as DIC, pre-eclampsia, thyrotoxicosis, pulmonary insufficiency * complete data; * patient must have at least one year of regular follow-up and hCG monitoring following onset of remission; * should have signed the consent form. Exclusion Criteria: * patients who are lost to follow-up or with incomplete data * patients who underwent total hysterectomy for evacuation of molar pregnancy * patients who are unable to complete the methotrexate treatment * patients who get pregnant within a year following remission * patients with a previous history of gestational trophoblastic neoplasia * patients with medical problems/complications that inhibit administration of methotrexate