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• W3163996840 abstract "A 17-year-old female patient without systemic disease presented to the emergency department because of lower abdominal pain for 1 day. Intermittent vaginal spotting was noted for 2 months. On physical examination, she was afebrile, with a pulse rate of 86 beats/min and blood pressure of 118/72 mm Hg. Whitish vaginal discharge without active bleeding was found on pelvic examination. Laboratory tests showed a positive urine pregnancy test result and an elevated serum β-human chorionic gonadotropin (HCG) 225,000 mIU/mL. Abdominal point-of-care ultrasonography was performed and demonstrated a lesion with multiple cystic areas in the uterine cavity (Figure 1 and Video E1, available online at http://www.annemergmed.com). Complete hydatidiform mole. The patient received dilatation and curettage 2 days later, and the pathology report revealed a hydatidiform mole without evidence of malignancy. She was asymptomatic, with an undetectable β-HCG level at follow-up 6 months later. Hydatidiform mole is a part of gestational trophoblastic disease, which can be partial (69 XXX or XXY), or complete (46 XX or XY).1Berkowitz R.S. Goldstein D.P. Clinical practice. Molar pregnancy.N Engl J Med. 2009; 360: 1639-1645Crossref PubMed Scopus (170) Google Scholar Prior molar pregnancy, extremes of maternal age, and history of spontaneous abortion are the risk factors for molar pregnancy.2Lurain J.R. Gestational trophoblastic disease I: epidemiology, pathology, clinical presentation and diagnosis of gestational trophoblastic disease, and management of hydatidiform mole.Am J Obstet Gynecol. 2010; 203: 531-539Abstract Full Text Full Text PDF PubMed Scopus (371) Google Scholar The most common presentations are vaginal bleeding, abdominal pain, and hyperemesis gravidarum.3Murphy R. Jahnke K. Houry D. Characteristics of patients who present to the emergency department with molar pregnancy.South Med J. 2008; 101: 797-799Crossref PubMed Google Scholar Point-of-care ultrasonography may help identify molar pregnancy.4Abdi A. Stacy S. Mailhot T. et al.Ultrasound detection of a molar pregnancy in the emergency department.West J Emerg Med. 2013; 14: 121-122Crossref PubMed Scopus (4) Google Scholar Sonographic features of the complete mole demonstrate an intrauterine mass containing diffuse cystic spaces without formation of fetal tissue in a classic “snowstorm” pattern, and only focal cystic spaces within the placenta in the partial mole.5Kirk E. Papageorghiou A.T. Condous G. et al.The accuracy of first trimester ultrasound in the diagnosis of hydatidiform mole.Ultrasound Obstet Gynecol. 2007; 29: 70-75Crossref PubMed Scopus (68) Google Scholar There may be a 2% to 3% risk of developing choriocarcinomas if the disorder is not treated. Surgical evacuation of the hydatidiform mole is the essential treatment.1Berkowitz R.S. Goldstein D.P. Clinical practice. Molar pregnancy.N Engl J Med. 2009; 360: 1639-1645Crossref PubMed Scopus (170) Google Scholar,2Lurain J.R. Gestational trophoblastic disease I: epidemiology, pathology, clinical presentation and diagnosis of gestational trophoblastic disease, and management of hydatidiform mole.Am J Obstet Gynecol. 2010; 203: 531-539Abstract Full Text Full Text PDF PubMed Scopus (371) Google Scholar Serial serum β-HCG measurements are required to detect residual disease.1Berkowitz R.S. Goldstein D.P. Clinical practice. Molar pregnancy.N Engl J Med. 2009; 360: 1639-1645Crossref PubMed Scopus (170) Google Scholar,2Lurain J.R. Gestational trophoblastic disease I: epidemiology, pathology, clinical presentation and diagnosis of gestational trophoblastic disease, and management of hydatidiform mole.Am J Obstet Gynecol. 2010; 203: 531-539Abstract Full Text Full Text PDF PubMed Scopus (371) Google Scholar https://www.annemergmed.com/cms/asset/efcd5020-e89b-47e6-9558-5185e373f0fa/mmc1.mp4Loading ... Download .mp4 (6.12 MB) Help with .mp4 files Video E1Transverse (at 00:00 to 00:06) and longitudinal (at 00:07 to 00:12) ultrasonography of the lower abdomen, showing a lesion with multiple cystic areas in the uterine cavity, without any fetal part." @default.
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• W3163996840 date "2021-06-01" @default.
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• W3163996840 title "Young Female With Lower Abdominal Pain" @default.
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• W3163996840 doi "https://doi.org/10.1016/j.annemergmed.2020.12.001" @default.
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