TY - JOUR
T1 - Trophoblastic pulmonary embolization after hysterectomy for invasive complete mole
T2 - A case report
AU - Garner, Elizabeth I.O.
AU - Chang-Lee, Wendy Y.
AU - Lu, Karen H.
AU - Goldstein, Donald P.
AU - Berkowitz, Ross S.
N1 - Copyright:
Copyright 2012 Elsevier B.V., All rights reserved.
PY - 1999/10
Y1 - 1999/10
N2 - BACKGROUND: Trophoblastic pulmonary embolization usually occurs after evacuation of a molar pregnancy when the uterus is larger than dates and the human chorionic gonadotropin level is > 100,000 mIU/mL. It has a dramatic onset, with dyspnea, tachypnea, bilateral pulmonary infiltrates and low Poz levels. Treatment requires supportive measures only. Intubation is rarely required. The clinical course is short-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 abortion 1, developed presumed trophoblas tic pulmonary embolization following abdominal hysterectomy for an invasive mole. The clinical course was typical of this condition, with spontaneous clearing in 72 hours with supportive measures only. CONCLUSION: Trophoblastic pulmonary embolization can occur following abdominal hysterectomy for invasive mole as well as after molar evacuation and should be considered part of the differential diagnosis if patients present postoperatively with acute respiratory distress.
AB - BACKGROUND: Trophoblastic pulmonary embolization usually occurs after evacuation of a molar pregnancy when the uterus is larger than dates and the human chorionic gonadotropin level is > 100,000 mIU/mL. It has a dramatic onset, with dyspnea, tachypnea, bilateral pulmonary infiltrates and low Poz levels. Treatment requires supportive measures only. Intubation is rarely required. The clinical course is short-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 abortion 1, developed presumed trophoblas tic pulmonary embolization following abdominal hysterectomy for an invasive mole. The clinical course was typical of this condition, with spontaneous clearing in 72 hours with supportive measures only. CONCLUSION: Trophoblastic pulmonary embolization can occur following abdominal hysterectomy for invasive mole as well as after molar evacuation and should be considered part of the differential diagnosis if patients present postoperatively with acute respiratory distress.
KW - Hysterectomy
KW - Invasive mole
KW - Pulmonary embolism
KW - Trophoblastic neoplasms
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M3 - Article
C2 - 10554759
AN - SCOPUS:0032748431
SN - 0024-7758
VL - 44
SP - 908
EP - 912
JO - Journal of Reproductive Medicine for the Obstetrician and Gynecologist
JF - Journal of Reproductive Medicine for the Obstetrician and Gynecologist
IS - 10
ER -