Presentation
Vaginal bleed following two months of amenorrhea - cause?
Patient Data
The uterus is grossly enlarged. An echogenic mass completely fills the uterus, giving rise to a snowstorm appearance and causing acoustic enhancement. Multiple vesicles can be seen all over the mass, giving the appearance of a 'bunch of grapes'. On Doppler uterine vascularity was found increased. Both ovaries are enlarged and show multiple cysts called theca lutein cysts. Examination of the liver did not reveal any metastatic lesions, suggesting a non-invasive mole. Associated gallstones are seen as an incidental finding.
Case Discussion
Complete hydatidiform mole (CHM) is usually associated with advanced gestational age, IUCD usage, OCP consumption, and repeated abortions. Our patient was a second gravida with two medical abortions in the past using the mifepristone regimen. She presented with bleeding PV following two months of amenorrhea. However, she did not have any hyperemesis. Her beta HCG levels were raised in the range of 60000 mIU/ml.
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