MOLAR PREGNANCY TWO YEARS AFTER HYSTEROSCOPIC ENDOMETRIAL RESECTION: A CASE REPORT
King Khalid University Hospital, College of Medicine, King Saud University, Riyadh, Saudi Arabia
Background: Pregnancies have been reported after endometrial ablation. This case may be the first molar pregnancy after hysteroscopic endometrial ablation.
Case: A 39-year-old with pelvic pain and menometrorrhagia received laparoscopic excision of endometriosis, left salpingo-oophorectomy and hysteroscopic endometrial resection. After 18 months of amenorrhea she presented with bleeding. Three months later she had profuse bleeding, β-hCG of 114,000 IU/L and no pregnancy on ultrasound. Laparoscopy was negative and D & C inconclusive. Following D&C β-hCG plateaued from over 200,000 IU/L to 4,500 IU/L. She was treated with methotrexate for molar pregnancy. β-hCG declined to < 5 IU/L 3 months later.
Conclusion: Endometrial ablation is not a method of birth control. Sterilization or other methods of birth control should be advised. Abnormal bleeding following endometrial ablation should be investigated.