Molar Pregnancy with Hyperthyroidism: A Therapeutic Challenge

Abstract

Gestational trophoblastic disease is a rare complication of pregnancy that may be associated with an increased likelihood of hyperthyroidism secondary to rising levels of human chorionic gonadotrophin (HCG). Most of these cases remain undiagnosed leading to thyrotoxic crisis during and after operative intervention. We report a case of molar pregnancy with secondary hyperthyroidism who presented to us with a history of vaginal bleeding, palpitations, hyperemesis and abdominal distension. She had hysterotomy under general anaesthesia but went in acute cardio-pulmonary distress during the post-operative period for which she required prolonged intubation and tracheostomy. She became euthyroid after 2 weeks with anti-thyroid drugs. In view of ultrasound findings and rising beta HCG, a diagnosis of invasive mole was made and was started on chemotherapy. She responded well to the treatment and was finally discharged after normalisation of HCG values.