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A Molar Pregnancy Detected by Following ß-Human Chorionic Gonadotropin Levels after a First Trimester Loss

From the University of Wisconsin-Madison Medical School, Department of Family Medicine, St. Luke’s Family Practice Residency, Milwaukee, WI 53207

Correspondence: Corresponding author: Lee T. Dresang, MD, University of Wisconsin Medical School, Department of Family Medicine, St. Luke’s Family Practice Residency, 1230 W. Grant Street, Milwaukee, WI 53215 (e-mail: ldresang{at}fammed.wisc.edu)

This case report summarizes the sequence of events that led to the detection of a molar pregnancy missed by ultrasound and initial pathology examinations. This patient illustrates that following serial quantitative ß-human chorionic gonadotropin (B-hCG) levels after spontaneous, therapeutic, and elective abortions will help detect potentially life-threatening molar and ectopic pregnancies. Further research is needed to determine the optimal frequency of B-hCG testing. For now, maternity care providers can follow the American College of Obstetrics and Gynecology recommendation that abnormal bleeding for more than 6 weeks after any pregnancy should be evaluated with B-hCG testing. Earlier testing may be considered.