Successful pregnancy following conservative surgical therapy of an invasive molar gestation.

BACKGROUND

An invasive mole is a form of persistent trophoblastic disease. The traditional surgical treatment is hysterectomy.

CASE: A young nullipara presented with a positive pregnancy test 6 months following a suction curettage for an incomplete abortion. Radiologic imaging was suspicious for intramural ectopic gestation. She was treated with methotrexate but became thrombocytopenic with failure to resolve the abnormal gestation. Surgical excision of the mass was performed. Pathologic evaluation revealed the diagnosis of invasive molar pregnancy. The beta-hCG levels remained negative for greater than a year. The patient subsequently conceived and underwent a cesarean delivery of a viable infant at 36 weeks gestation.

CONCLUSION

Conservative surgical excision can successfully treat invasive molar gestation. This should be considered for patients who desire future fertility and have contraindications to medical therapy.