Molar pregnancies are rare complications that can have potentially devastating effects, including neoplastic disease. Given the potential for malignant conversion, proper diagnosis of molar pregnancy is crucial. This case demonstrates the utility of point-of-care ultrasound (POCUS) for molar pregnancy in the emergency department (ED). The patient was a 43-year-old G8P1, 8-week-pregnant female who presented to the emergency department for evaluation of abdominal pain. Her physical exam was notable for abdominal tenderness and a normal pelvic exam. Evaluation included basic labs with a quantitative serum beta human chorionic gonadotropin (βhCG), urinalysis, and vaginal wet mount. Her results were unremarkable with the exception of elevated βhCG to 83,000 mIU/mL. A transabdominal POCUS was performed which showed a heterogeneous mass with several anechoic areas, concerning for a molar pregnancy. Patient was seen by obstetrics and gynecology (OB-GYN) and a transvaginal ultrasound showed similar findings. Dilation and evacuation were performed approximately 5 hours after initial diagnosis on POCUS. Use of POCUS was crucial for expedient diagnosis and appropriate treatment in this patient, highlighting the utility of POCUS for pregnant patients in the ED.
Topics: Molar pregnancy, gestational trophoblastic disease, hydatidiform mole, point of care ultrasound.
© 2022 Wietecha, et al.