Ultrasound Detection of a Molar Pregnancy in the Emergency Department
A 32 year-old female presented to the emergency department (ED) with complaints of mild vaginal spotting accompanied by uterine cramping. She was referred to the ED for an “abnormal pregnancy.” She was a G1P0 and her last menstrual period was 7 weeks 5 days prior. Physical examination demonstrated a well appearing female with normal vital signs. Speculum exam showed a normal appearing cervix, without active bleeding or cervical discharge. On bimanual exam, the cervical os was closed and there was no uterine or adnexal tenderness. Laboratory testing was significant for an elevated serum beta-HCG of 138,596. Bedside emergency ultrasound (EUS) was then performed and demonstrated multiple grape-like clusters within the uterus (). No definitive intrauterine pregnancy was detected. A radiologist performed ultrasound was then ordered and confirmed the diagnosis of a molar pregnancy.