Data from the early days of chemotherapy treatment for trophoblast disease show clearly that there is a relationship between the level of elevation of hCG at presentation, the presence of distant metastases and the reducing chances of cure with single-agent chemotherapy. This relationship and the impact on treatment choice and cure rate were first codified by the Bagshawe scoring system published in 1976 . Subsequently there have been a number of revisions and parallel systems introduced that are broadly similar to this original. In Table 15.2 the revised 2000 FIGO prognostic score table is shown. From assessment of these parameters, an estimate of the risk category can be obtained and patients offered initial treatment either with single-agent chemotherapy if their score is 6 or less or multiagent combination chemotherapy for scores of seven and over .
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The first trimester is very important for the mother and the baby. For most women it is common to find out about their pregnancy after they have missed their menstrual cycle. Since, not all women note their menstrual cycle and dates of intercourse, it may cause slight confusion about the exact date of conception. That is why most women find out that they are pregnant only after one month of pregnancy.