Case 54: Molar Pregnancy || Hydatidiform Mole || TVS || Doppler

          

Clinical Features:

A 22 years old female patient came with

- Amenorrhoea for 4 months

- Small pervaginal bleeding for several days

Ultrasound Features:

- Bulky uterus.

- Heterogeneously echogenic central intrauterine mass with internal diffuse cystic spaces is seen without any associated fetal part forming the ‘snow-storm’ appearance.

- Color Doppler shows low impedance flow towards the lesion.

Remember:

- Molar pregnancy can be easily diagnosed on transabdominal ultrasound. TVS & MRI help exclude invasive mole.

- Tornado-shaped bridging vessels, myometrial thinning & exophytic mass should be excluded.

Ultrasound Images:

Fig: Transabdominal ultrasound, longitudinal section of the uterus; Bulky uterus with heterogeneously echogenic central intrauterine mass with internal diffuse cystic spaces without any associated fetal part forming the ‘snow-storm’ appearance suggesting molar pregnancy.

Fig: Transabdominal ultrasound, transverse section of the uterus; Bulky uterus with heterogeneously echogenic central intrauterine mass with internal diffuse cystic spaces without any associated fetal part forming the ‘snow-storm’ appearance suggesting molar pregnancy.

Fig: Transabdominal ultrasound, longitudinal section of the uterus; Color Doppler shows predominantly peripheral vascularity

Fig: Transvaginal ultrasound (TVS), longitudinal section of the uterus; Bulky uterus with heterogeneously echogenic central intrauterine mass with internal diffuse cystic spaces without any associated fetal part forming the ‘snow-storm’ appearance suggesting molar pregnancy.

Fig: Tranvaginal ultrasound (TVS), longitudinal section of the uterus; Color Doppler shows predominantly peripheral vascularity

Fig: Tranvaginal ultrasound (TVS), longitudinal section of the uterus;  Color Doppler shows low impedance flow towards the lesion.

YouTube Video Link:

https://youtu.be/T5Mz7Aw0D3s