**Question:** Follow-up in a patient of H mole is done by:

A. Regular clinical examination
B. Serum beta-human chorionic gonadotropin (beta-hCG) level monitoring
C. Ultrasonography
D. PAP smear

**Core Concept:**
H mole, also known as hydatidiform mole, is a pregnancy complication characterized by the rapid growth of trophoblastic cells that form a cystic mass in the uterus. This can lead to excessive production of beta-human chorionic gonadotropin (beta-hCG), a hormone produced during normal pregnancy. In the context of H mole, monitoring beta-hCG levels helps assess disease activity and response to treatment.

**Why the Correct Answer is Right:**
The correct answer is monitoring beta-hCG levels (option B) since:
1. H mole is characterized by high levels of beta-hCG which can fluctuate significantly over time.
2. Monitoring beta-hCG levels helps assess disease activity, detect disease recurrence, and evaluate treatment response.
3. Clinical examination (option A) and PAP smear (option D) are not specific to H mole and may not reflect disease progression or regression accurately.
4. Ultrasonography (option C) is essential for imaging the uterus and detecting complications like choriocarcinoma, but it does not directly monitor disease activity.

**Why Each Wrong Option is Incorrect:**
A. Regular clinical examination (option A) may not reflect beta-hCG levels, which is the primary marker for H mole disease activity.
B. Monitoring PAP smear (option D) is not specific to H mole and may not accurately assess disease progression or regression.
C. Ultrasonography (option C) is important for imaging complications and assessing gestational sac but cannot replace beta-hCG monitoring for assessing disease activity.
D. Regular monitoring of PAP smear (option D) is not specific to H mole and may not accurately assess disease progression or regression.

**Clinical Pearl:**
Choriocarcinoma is a rare but potentially life-threatening complication of H mole, often presenting with increasing beta-hCG levels and requires early detection and intervention. Monitoring beta-hCG levels is crucial for early detection and management of choriocarcinoma.