A 34-Week Size Uterus with a Complete Hydatidiform Mole: Hook Effect and Severe Anemia with No Vaginal Bleeding

Autor: Rodney McLaren, Vijaya Bayya, Mohamad Irani
Jazyk: angličtina
Rok vydání: 2018
Předmět:
Zdroj: Case Reports in Obstetrics and Gynecology, Vol 2018 (2018)
Druh dokumentu: article
ISSN: 2090-6684
2090-6692
DOI: 10.1155/2018/8201949
Popis: Complete hydatidiform mole is an abnormal pregnancy that usually presents with vaginal bleeding and markedly elevated serum ß-hCG levels. We report a rare case of complete hydatidiform mole occurring in a 16-year-old nulligravid who presented with a 34-week size uterus and a relatively low serum ß-hCG level (722 IU/L)—likely related to the “hook effect”—and severe anemia (hemoglobin: 6.1 g/dL) despite the absence of vaginal bleeding. She also reported right flank pain and was diagnosed with moderate right hydronephrosis owing to the compression exerted by the enlarged uterus on the right ureter. The patient received a total of 6 units of packed red blood cells and was managed by dilation and evacuation followed by serial monitoring of serum ß-hCG levels. Therefore, complete mole can present with symptoms related to an enlarged uterus and severe anemia before the occurrence of vaginal bleeding. It is also important to note that a negative urine pregnancy test or relatively low serum ß-hCG level should prompt repeating the measurement on diluted sample to prevent the “hook effect.”
Databáze: Directory of Open Access Journals
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