Advanced Gestational Presentation of Complete Molar Pregnancy: Clinical Insights and Lessons for Early Detection

Molar pregnancy is a rare form of gestational trophoblastic disease characterized by abnormal trophoblastic proliferation and villous edema. It is classified into complete and partial moles, with potential complications such as hemorrhage and progression to gestational trophoblastic neoplasia (GTN). Early detection and prompt management are critical to prevent severe outcomes. This case report discusses a delayed presentation of a complete molar pregnancy diagnosed at an advanced gestational age. A 20-year-old primigravida presented at 24.5 weeks of gestation with vaginal bleeding and abdominal pain. Clinical examination revealed no fetal heart rate, and ultrasound demonstrated a characteristic “snowstorm” appearance, confirming a complete molar pregnancy. Beta-hCG levels were markedly elevated at 92,880 mIU/mL. Uterine evacuation was performed via suction curettage, followed by serial beta-hCG monitoring. Histopathological examination confirmed the diagnosis. The patient’s postoperative recovery was uneventful; however, financial constraints led to discharge against medical advice, with incomplete follow-up. This case underscores the importance of early diagnosis, rigorous follow-up, and tailored management strategies in preventing complications associated with molar pregnancy. Improved accessibility to first-trimester ultrasound and beta-hCG screening can significantly enhance patient outcomes and reduce morbidity.