Eio. Garner et al., Trophoblastic pulmonary embolization after hysterectomy for invasive complete mole - A case report, J REPRO MED, 44(10), 1999, pp. 908-912
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.