Perforating Mole in a Nullipara Leading to Massive Hemoperitoneum: Fertility Preservation, a Challenge

Nilanchali Singh1, Shilpa Singh2, Esha Sharma2, Shalini Rajaram2 and Neha Mishra3*

1Department of Obstetrics and Gynecology, Maulana Azad Medical College, India
2Department of Obstetrics and Gynecology, University College of Medical Sciences and Guru Teg Bahadur Hospital, India
3Department of Obstetrics and Gynecology, All India Institute of Medical Science, India

^*Correspondance to: Neha Mishra 

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Abstract:

Invasive mole, also known as chorioadenoma detrusens, is a neoplastic entity involving the trophoblastic tissues and penetrating deep into the myometrium. It may present as massive intraperitoneal hemorrhage, following uterine perforation, in which uterine conservation becomes difficult. We report a rare case of chorioadenoma detrusens, presenting as massive hemoperitoneum in a nulliparous woman, in which, a challenging decision of conserving the uterus was taken in low resource settings. Operative findings showed hemoperitoneum of 1000 cc, an enlarged uterus with a rent on fundus with torrential bleeding through it and grape-like vesicles popping from it. Two more thin uterine blebs representing thinned out myometrium, were seen on the anterior and right lateral surface of uterus on the verge of rupture. Hemostatic sutures were applied on the rent and bleeding was controlled.

Keywords:

Invasive mole; Hemoperitoneum; Conservative management

Cite the Article:

Mishra N. Perforating Mole in a Nullipara Leading to Massive Hemoperitoneum: Fertility Preservation, a Challenge. Ann Clin Case Rep. 2020; 5: 1806.