Characteristics of patients who present to the emergency department with molar pregnancy

Objective: The purpose of this Study was to determine presenting signs/symptoms and risk factors in emergency department (E-D) patients ultimately diagnosed with molar pregnancy. Methods: A retrospective review of ED medical records using a standardized abstraction sheet was conducted over a 10-year period (1995-2005) from three EDs. Results: Records were available oil 44 patients (mean age 25.2 years, 75% African-American) with a diagnosis of molar pregnancy who had been seen in the ED. Almost half presented with abdominal pain, nausea/vomiting, and/or vaginal bleeding. Forty-three percent had a history of sexually transmitted disease; 41%, had a history of abdominal or gynecological surgery; and three patients had a documented prior molar pregnancy. Of 22 ultrasounds performed, 68% were noted to have a molar pregnancy. Only five patients had molar pregnancy listed in the differential diagnosis at their initial visit. Conclusion: Patients who presented with molar pregnancy tended to be young, multiparous, and African-American. The most common presenting complaint was vaginal bleeding, and file ultrasound was not diagnostic of molar pregnancy in almost one-third of the cases.