Gestational choriocarcinoma diagnosed on retained products two weeks post partum following massive fetomaternal haemorrhage at term

Abstract

A 36-year-old woman presented at 38 weeks gestation with a two week history of reduced fetal movements. The cardiotocogram was abnormal and the infant was delivered by caesarian section, weighing 3360 grams. The baby required full resuscitation. A full blood count showed a haemoglobin of 39 g/L. The Kleihauer-Betke test was positive and estimated to be 113 mls of packed fetal red blood. The placenta was bulky and pale with a trimmed fresh weight of 914.5 grams. The fetal vessels appeared empty. Microscopically, there was a focal area of necrosis.