Management approach of a postmenopausal woman with a completely massive molar pregnancy: A case report

Ann Med Surg (Lond). 2022 Jun 30:79:104099. doi: 10.1016/j.amsu.2022.104099. eCollection 2022 Jul.

Abstract

Introduction and importance: Molar pregnancy typically manifests in the first trimester and is associated with several symptoms, including vaginal bleeding and larger than expected uterine size. The hallmark symptoms of this disorder are rapid uterine growth, nausea and vomiting, and an unusually high quantitative bhCG level. Ultrasonography is a reliable and sensitive technique for the diagnosis of complete molar pregnancy, which showed a "snow storm" pattern as a result of hydropic degeneration in chorionic villi.Total hysterectomy is the best treatment option for older-age women who do not desire to have children. It appears to greatly minimize the risk of later GTN.

Case presentation: In this case study, we present a 46-year-old female patient who presented with vaginal bleeding and weakness. A transvaginal Ultrasound revealed a mixed solid and cystic mass-like structure in her pelvis. A total abdominal hysterectomy was performed on the patient due to severe vaginal bleeding.After three months, the beta-HCG level had entirely stabilized. During the follow-up, no symptoms of gestational trophoblastic neoplasia were found.

Clinical discussion: A case report of postmenopausal women with a completely massive molar pregnancy with significant grape-like bleeding is a rare case of life-threatening conditions that may be discovered as a result of persistent significant vaginal bleeding.

Conclusions: complete hysterectomy should be performed to avoid significant complications such as bleeding, hypovolemic shock, and risk of GTN.

Keywords: Amenorrhea; Molar pregnancy; Patient; Symptoms; Vaginal bleeding.

Publication types

  • Case Reports