HPI
A 20-year-old G2P1 female presents with nausea, vomiting, and back pain x1 week. She is breastfeeding and sexually active. LMP was about 2 months prior, and she had spotting 3 weeks ago. Her vital signs are within normal limits. Patient’s urine HCG in the ED is positive.
Ultrasound
Transabdominal ultrasound of the pelvis reveals an irregularly shaped gestational sac with cystic structures, subchorionic hemorrhage, no definitive IUP, and no pelvic free fluid. Transverse (clip 1) and sagittal (clip 2) planes are shown below.
Case Conclusion
Her serum beta-HCG is found to be >270,000, disproportionate with gestational age. Ultrasound images are consistent with molar pregnancy. OBGYN was consulted for evaluation, and the patient was scheduled for an outpatient D&C.
Characteristic Findings of Molar Pregnancy on POCUS
A complete molar pregnancy appears as a heterogeneous intrauterine mass with many anechoic, fluid-filled sacs, resembling a “snowstorm” or “grape-like” clusters from hydropic swelling of villi. A fetus is absent.
Partial molar pregnancies may show abnormal fetal tissue alongside these features.
Early detection facilitates timely referral for definitive management, which is important as disease can progress to persistent trophoblastic disease or choriocarcinoma
Another grape catch on POCUS!
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Happy scanning!