Uterine rupture following incomplete molar pregnancy: a case report

Abstract

Background: In molar pregnancy, when hydatidiform changes are local and some embryonic components are observed, the term of partial mole is used. The risk of persistent trophoblastic tumor after partial mole is much lower than complete mole. In this persistent cases almost all are non metastatic. The aim of this study is to report a case of uterine rupture following incomplete molar pregnancy.Case presentation: The patient was a 26 year old woman with obstetric history of an abortion and one molar pregnancy and no child. She was referred to emergency unit in Ghaem University Hospital, Mashhad, Iran in May 2011. She had an evacuation curettage following molar pregnancy three months before and without any follow up visit. The patient was referred to emergency unit with hemorrhagic shock. She immediately underwent laparotomy. The uterine fundal rupture was repaired and evacuation curettage performed. In post operative evaluation, she had a nine millimeter metastatic nodule in base of right Lung. As a patient in low risk stage III, she received weekly intramuscular methotrexate (40mg/m2) for six courses. In follow up visit -hCG titer was negative (<10miu/ml) at 5th week. Conclusion: In cases of in complete molar pregnancy risk of metastasis is very low. Serial beta-hCG titer is the most accurate method for detection of persistent gestational trophoblastic disease (GTN). In neglected cases like this case preservation of ruptured uterus in GTN is possible.

Keywords

• Partial hydatidiform mole
• trophoblastic tumor
• uterine rupture