Characteristics of patients who present to the emergency department with molar pregnancy.

OBJECTIVE

The purpose of this study was to determine presenting signs/symptoms and risk factors in emergency department (ED) patients ultimately diagnosed with molar pregnancy.

METHODS

A retrospective review of ED medical records using a standardized abstraction sheet was conducted over a 10-year period (1995-2005) from three EDs.

RESULTS

Records were available on 44 patients (mean age 25.2 years, 75% African-American) with a diagnosis of molar pregnancy who had been seen in the ED. Almost half presented with abdominal pain, nausea/vomiting, and/or vaginal bleeding. Forty-three percent had a history of sexually transmitted disease; 41% had a history of abdominal or gynecological surgery; and three patients had a documented prior molar pregnancy. Of 22 ultrasounds performed, 68% were noted to have a molar pregnancy. Only five patients had molar pregnancy listed in the differential diagnosis at their initial visit.

CONCLUSION

Patients who presented with molar pregnancy tended to be young, multiparous, and African-American. The most common presenting complaint was vaginal bleeding, and the ultrasound was not diagnostic of molar pregnancy in almost one-third of the cases.