Moamar A, Anupama B, Khansa W, Thin TH
Case: We describe clinical case of a woman who presented with a very rare diagnosis of heterotopic pregnancy with a coincident finding of intrauterine complete molar pregnancy and a tubal unruptured ectopic pregnancy. She was asymptomatic at the first presentation with features of a vesicular mole in the uterus and high suspicion of ectopic pregnancy on the left side of the uterus by transvaginal ultrasound scan (TVS). The serum Beta Human Chorionic Gonadotrophin (HCG) was 96915 U/L which was significantly high. She also had mild anemia. It was challenging to offer the best of treatment modalities as we did not find a similar case in the literature. Outcome: After full counseling, the patient underwent suction curettage of the uterus and medical treatment with Methotrexate. The serum BHCG level was monitored and it reached zero in a few weeks. She made a good recovery without any complication. Conclusion: Surgical evacuation for intrauterine complete mole followed by medical methotrexate therapy for coincident unruptured tubal ectopic pregnancy is optimal management for such cases.
