A 29-year-old primigravid woman comes to the emergency department with vaginal bleeding and pelvic pressure for several hours. Over the past 2 weeks, she had intermittent nausea and vomiting. A home urine pregnancy test was positive 10 weeks ago. She has had no prenatal care. Her pulse is 80/min and blood pressure is 150/98 mm Hg. Physical examination shows warm and moist skin. Lungs are clear to auscultation bilaterally. Her abdomen is soft and non-distended. Transvaginal ultrasound shows a central intrauterine mass with hypoechoic spaces; there is no detectable fetal heart rate. Hydropic villi are evacuated from the uterus during dilation and curettage. Which of the following should be closely monitored in this patient after the procedure?

Question

A 29-year-old primigravid woman comes to the emergency department with vaginal bleeding and pelvic pressure for several hours. Over the past 2 weeks, she had intermittent nausea and vomiting. A home urine pregnancy test was positive 10 weeks ago. She has had no prenatal care. Her pulse is 80/min and blood pressure is 150/98 mm Hg. Physical examination shows warm and moist skin. Lungs are clear to auscultation bilaterally. Her abdomen is soft and non-distended. Transvaginal ultrasound shows a central intrauterine mass with hypoechoic spaces; there is no detectable fetal heart rate. Hydropic villi are evacuated from the uterus during dilation and curettage.  Which of the following should be closely monitored in this patient after the procedure?

Quizplus · Accepted Answer

Eductional Objective: A complete hydatidiform mole is composed of multiple cystic edematous hydropic villi resulting from trophoblast proliferation.  Serial measurements of B-hCG should be performed following evacuation of a hydatidiform mole.  Persistently elevated or rising levels may signify the development of an invasive mole or choriocarcinoma.

A 29-Year-Old Primigravid Woman Comes to the Emergency Department with Vaginal