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Partial hydatidiform mole with spontaneous ovarian hyperstimulation syndrome

Isabel Sousa, André Sampaio, Joana Sampaio, Rui Mendonça, Tiago Rocha, Carlos Ponte, Rui César

 

The authors present an atypical case of partial hydatidiform mole (PHM). Woman, 36 years old, who went to the emergency room for abdominal pain associated with eleven-week pregnancy. Echography revealed the presence of hyper stimulated ovaries leading to diagnosis of spontaneous Ovarian Hyperstimulation Syndrome (OHSS). Blood sample revealed high levels of hCG (1422000 U/L), which associated with the ultrasound finding of placenta with vesicular areas, led to the suspicion of PHM. With this suspicion and the high value of nuchal translucency, amniocentesis was performed, confirming the diagnosis of PHM – 69, XXX. The pregnant, with history of hypothyroidism, presented analytic hyperthyroidism which is rare in this clinical situation. The medical termination of pregnancy resolved this pathologic situation and also hyperthyroidism condition. Hydatidiform mole, with increased levels of hCG, is one of the three possible mechanisms for spontaneous OHSS.