Molar pregnancy

Case contributed by Anna Khomenko
Diagnosis certain

Presentation

The patient presented to the emergency room with continuous vaginal bleeding, lower abdominal pain, and vomiting for 1 month. The patient was diagnosed with complete molar pregnancy and had D&C procedure a month ago. HCG blood test was obtained and came back positive.

Patient Data

Age: 25 years
Gender: Female
ultrasound

Enlarged uterus with heterogeneous multicystic areas giving a snowstorm appearance. Findings are suggestive for gestational trophoblastic disease/molar pregnancy; choriocarcinoma cannot be entirely excluded. Adjacent anechoic region likely reflects a collapsed gestational sac. No obvious fetal parts are noted within.

Enlarged multicystic bilateral ovaries likely reflect thecal lutein cysts secondary to ovarian hyperstimulation in the settings of molar pregnancy. Trace amount of free fluid within cul-de-sac. Recommended OB/GYN consult for further evaluation. 

Case Discussion

The patient's physical and history, ultrasound findings. and positive Beta-hCG level are suggestive of gestational trophoblastic disease, molar pregnancy. The patient was evaluated by OB/GYN and was scheduled for D&C the following morning. 

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