Ruptured tubal hydatidiform mole

Ruptured ectopic gestation is a life threatening medical emergency especially in developing countries. However, the occurrence of hydatidiform mole in ruptured tubal pregnancy is uncommon.

A consecutive analysis of patients with hydatidiform mole in ruptured tubal gestation over a 9-year period in a tertiary hospital.

Of a total of 101 females with ectopic gestations, only five had ruptured tubal hydatidiform mole. The ages ranged from 20-37years and they all presented with acute abdominal symptoms which necessitated emergency surgical intervention. Intra-operative findings revealed ruptured/ leaking tubal gestation. The excised tissue specimens showed hydatidiform mole characterized by circumferential trophoblastic proliferation, hydropic degeneration and stromal karyorrhexis. Patients' serial HCG levels were monitored before discharge.

Ruptured tubal hydatidiform mole is uncommon and strict histologic criteria are important in diagnosis. Serial HCG levels must be monitored in individual patients to forestall development of malignant trophoblastic disease.