Neglected uterine perforation on a molar pregnancy: Case report

Silent uterine perforation following aspiration for molar pregnancy is a rare but critical complication that can significantly impact maternal prognosis. Early detection and prompt intervention are crucial to prevent severe outcomes. This case highlights the importance of vigilant follow-up and clinical suspicion in managing such cases.

A 53-years-old patient, presented 1 month after an aspiration procedure on a molar pregnancy with abdominal pain, physical examination found tachycardia, hypotension, minimal vaginal bleeding and significant pain on uterine mobilization. Ultrasound showed a discontinuity on the uterin wall on the fundus and abundant peritoneal fluid reaching Morison's pouch. The patient underwent surgery with conservative treatment.

Uterine perforation after aspiration for molar pregnancy is a rare but serious complication, often requiring prompt surgical intervention. Delayed symptoms, such as abdominal pain and shock, may complicate diagnosis. This case highlights the importance of strict follow-up, as failure to monitor beta-hCG levels can lead to severe outcomes. While uterine perforations commonly occur at the fundus, complications like massive hemorrhage or hemoperitoneum may arise. This report emphasizes the critical role of early monitoring, early detection, and prompt intervention in improving maternal prognosis after molar pregnancy evacuation.

Silent uterine perforation after molar pregnancy evacuation is a serious, often overlooked complication. Prompt recognition, diligent follow-up, and regular monitoring of beta-hCG levels are essential for preventing severe outcomes and improving maternal prognosis in such cases.