Publication: A Rare Case of Large Hydatidiform Mole Mimicking a Term Pregnancy
Date
2022
Journal Title
Journal ISSN
Volume Title
Publisher
Kathmandu University
Abstract
ABSTRACT
Molar pregnancy is a type of abnormal pregnancy that usually presents with
amenorrhea, vaginal bleeding and elevated serum ß-hCG levels. We report a rare
case of complete hydatidiform mole occurring in a 46-year-old P2L2 lady who
presented with a term size uterus and elevated serum ß-hCG level (> 15,00,000 per
deciliter, anemia (hemoglobin: 8.1 g/dL), difficulty in breathing and minimal vaginal
bleeding. During the course of her evaluation, she had profuse vaginal bleeding,
she underwent suction and evacuation, but bleeding was not controlled despite
measures to control it. She was given uterotonics and antifibrinolytic agents and
uterine artery ligation. But was proceeded with emergency hysterectomy for
uncontrolled hemorrhage. The content of suction and evacuation was vesicles with
blood clots and histopathology was reported as complete hydatidiform mole. The
patient received a total of 4 units of packed red blood cells. She was discharged
from hospital on 5th postoperative day and was followed up serial serum ß-hCG
level. Therefore, complete mole can present with enlarged uterus, vaginal bleeding
and anemia. It is also important to note that intractable bleeding following suction
and evacuation not being controlled with uterotonics and antifibrinolytic agents
and uterine artery ligation may require hysterectomy to save the patient’s life.
KEY WORDS
Elevated serum ß-hCG level, Suction and evacuation, Term size uterus, Vaginal
bleeding
Description
Shrestha A,1 Bastakoti R,1 Pandey N,1 Poudel R,2 Ranjit S,3 Makaju R4
1Department of Obstetrics and Gynecology
2Department of Radiology
3Department of Anesthesia
4Department of Pathology
Dhulikhel Hospital, Kathmandu University Hospital
Dhulikhel, Kavre, Nepal
Keywords
Elevated serum ß-hCG level, Suction and evacuation, Term size uterus, Vaginal bleeding