Eagan Danielle, Jeter Natashia
Southeastern Health Medical Center, United States.
Union Medical Center, 322 W South St, Union, SC 29379, United States.
Case Rep Womens Health. 2016 Oct 19;12:11-14. doi: 10.1016/j.crwh.2016.10.002. eCollection 2016 Oct.
Highlight a complete molar pregnancy with possible complications and pertinent clinical information to aid doctors in recognizing the disease quickly to provide treatment to limit adverse outcomes.
Complete molar pregnancy is rare and compromises 1:500-1:2000 pregnancies [1-4]. As technology has improved, the presentation of complete molar pregnancy has changed [1,5-6].
A 19-year old African American female presented to the emergency room (ER) three times within 14 days for abdominal pain. A pregnancy test was positive and on the third visit quantitative β-human chorionic gonadotropin (HCG) was elevated without signs of an intrauterine pregnancy (IUP). Dilation and curettage (D&C) was done with small perforation of the uterus. Pathology report indicated a complete molar pregnancy. The patient failed to follow-up and returned to ER 22 days later where an abdominal mass was found prompting surgery. Hematomas and abdominal adhesions were removed and again pathology showed a complete molar pregnancy. Follow-up HCG levels failed to decrease appropriately so the patient was referred to oncology where metastatic choriocarcinoma of the liver was diagnosed. Chemotherapy was initiated and HCG monitored. Patient was readmitted for infections and complications, but did eventually have her HCG return to zero.
Clinical Key, Purdue Library, and UpToDate were used to search for literature.
Prompt recognition of a complete mole may lead to a less extensive disease process. Presentation has recently changed so it is important to know signs. Patient compliance likely results in fewer complications and costs.
强调完全性葡萄胎伴可能的并发症及相关临床信息，以帮助医生快速识别该疾病，从而提供治疗以限制不良后果。
完全性葡萄胎较为罕见，在妊娠中占比为1:500 - 1:2000[1 - 4]。随着技术的进步，完全性葡萄胎的表现发生了变化[1,5 - 6]。
一名19岁的非裔美国女性在14天内三次因腹痛前往急诊室。妊娠试验呈阳性，第三次就诊时定量β - 人绒毛膜促性腺激素（HCG）升高，但无宫内妊娠（IUP）迹象。进行了刮宫术（D&C），术中子宫出现小穿孔。病理报告显示为完全性葡萄胎。患者未进行随访，22天后返回急诊室，此时发现腹部有肿块，遂进行手术。清除了血肿和腹部粘连，病理再次显示为完全性葡萄胎。随访期间HCG水平未能适当下降，因此患者被转诊至肿瘤科，诊断为肝转移性绒毛膜癌。开始进行化疗并监测HCG。患者因感染和并发症再次入院，但最终HCG恢复至零。
使用Clinical Key、普渡大学图书馆和UpToDate搜索文献。
及时识别完全性葡萄胎可能会使疾病进程不那么严重。其表现最近有所变化，因此了解相关体征很重要。患者的依从性可能会减少并发症和费用。
