[Diagnosis of molar pregnancy by hysteroscopy].

BACKGROUND

Gestational trophoblastic disease has a high incidence worldwide. Proper pre-evacuation diagnosis must be performed due to the risk of malignant complications associated with hydatidiform moles. Diagnosis of early molar pregnancies might be elusive due to atypical clinical manifestations and inconclusive ultrasonographic findings.

OBJECTIVE

Report on the efficiency and precision by hysteroscopy for the diagnosis of molar pregnancy in one particular case.

CLINICAL CASE: Thirty-year old woman, 5.6-week pregnant, suffering from pelvic pain, uterine bleeding and high concentrations of human chorionic gonadotropin beta fraction (beta-hCG). Ultrasonography suggested inconclusively either a hematoma or a gestational sac so that further evaluation by hysteroscopy had to be performed in order to reach a proper diagnosis.

RESULTS

Hysteroscopic evaluation provided conclusive diagnostic images of hydropic degeneration of the chorionic villi. Histopathological evaluation confirmed a molar pregnancy. The mole was removed by uterine curettage and beta-hCG tests followed.

CONCLUSIONS

Hysteroscopy is a useful tool for diagnostic protocol in case of early atypical molar pregnancy.