Abstract
Molar pregnancies are associated with extremely high levels of BhCG, out of proportion to the stage of pregnancy. However, urine and serum BhCG assays can paradoxically be negative, despite the high BhCG levels, leading to misdiagnosis and delayed treatment. This is due to saturation of the assay by the BhCG molecules. We present such a case where the initial urine pregnancy test was negative in an advanced complete molar pregnancy. Primary care and emergency department physicians should be mindful of this possibility and go on to do serum BhCG with sample dilution in cases where pregnancy is strongly suspected.
Highlights
Molar pregnancy is an abnormal pregnancy event
They present with exaggerated symptoms of pregnancy: severe nausea and vomiting, bleeding per vagina, abdominal pain or mass [2]. They may present with thyrotoxicosis or preeclampsia. These symptoms are thought to be due to grossly elevated levels of BhCG
BhCG is produced by trophoblastic tissue; the excessive proliferation of trophoblast in hydatidiform mole produces extremely high levels of BhCG
Summary
Ka Hee Chuaa*, Sze Ching Hongb, Bernard Su Min Cherna, Cynthia Chia Yng Kewc a Department of Obstetrics & Gynecology, KK Women’s and Children’s Hospital, 100 Bukit Timah Road, Singapore 229899 b Mount Alvernia Medical Centre, Singapore 574623 c Mount Elizabeth Novena Specialist Centre, Singapore 329563. Received date: October 23, 2016; Accepted date: November 14, 2016; Published date: November 21, 2016 Citation: Chua KH, Min S, Chern B, et al A case of hook effect in molar pregnancy. Crit Care Obst&Gyne. 2016, 2:5.
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