Trophoblastic pulmonary embolization after hysterectomy for invasive complete mole - A case report

BACKGROUND: Trophoblastic pulmonary embolization usually occurs after evacu ation of a molar pregnancy when the uterus is larger than dates and the hum an chorionic gonadotropin level is >100,000 mIU/mL. If has a dramatic onset , with dyspnea, tachypnea, bilateral pulmonary infiltrates and low Po-2 lev els. Treatment requires supportive measures only. Intubation is rarely requ ired. The clinical course is shout-lived, with gradual improvement after 48 hours and complete resolution in 72 hours. There are no long-term sequelae . Differential diagnosis includes pulmonary embolization,fluid overload and aspiration. CASE: A 27-year-old, Caucasian woman, gravida 4, para 2, spontaneous aborti on 1, developed presumed trophoblastic pulmonary embolization following abd ominal hysterectomy for an invasive mole. The clinical course was typical o f this condition, with spontaneous cleaving in 72 hours with supportive mea sures only. CONCLUSION: Trophoblastic pulmonary embolization can occur following abdomi nal hysterectomy for invasive mole as well as after molar evacuation and sh ould be considered part of the differential diagnosis if patients present p ostoperatively with acute respiratory distress.