Complete molar pregnancy: A case report

Introduction: Complete hydatidiform mole, a form of gestational trophoblastic disease, occurs when one sperm fertilizes an empty ovum. Complete trophoblastic proliferation is associated with elevated serum beta human chorionic gonadotropin levels and absence of a fetus. Classic clinical features include abnormal vaginal bleeding, hyperemesis, and enlarged uterus for gestational age. Less common features include hyperthyroidism, early onset pre-eclampsia, and bilateral ovarian thecalutein cysts. Case Report: We present a case of a complete molar pregnancy of a woman who presented to the emergency department at 18 and 4/7 weeks with complaints of irregular vaginal spotting. Serum beta human chorionic gonadotropin level was noted to be 59,401. Transvaginal ultrasound notable for absence of intrauterine gestation with complex heterogeneous material within the uterus. The patient underwent suction dilatation and curettage. Histological examination of curettings confirmed a complete hydatidiform mole. The patient with persistently elevated blood pressures post-operatively necessitated workup for pre-eclampsia, which was negative. Given elevated blood pressures, the patient was started on Labetalol 200 mg twice daily with improvement one month post-procedure. Today, she no longer requires anti-hypertensive medication and beta human chorionic gonadotropin level has appropriately down trended. Conclusion: Our case highlights the need for early imaging to detect abnormalities like hydatidiform moles, which pose significant risks. Early detection improves patient outcomes and ensures proper post-operative care.