The answer is A. Complete hydatidiform mole
A complete hydatidiform mole is characterized by the presence of a uterine cavity filled with trophoblastic tissue, presenting as a “snowstorm” or “grape-like” appearance on ultrasound, without any identifiable fetal tissue. This condition results from the fertilization of an egg with an inactive nucleus by one or two sperm, leading to a gestation with no fetal development. Patients often present with symptoms of early pregnancy, including missed periods and positive pregnancy tests, along with markedly elevated serum β-hCG levels, uterine enlargement greater than expected for gestational age, and in some cases, symptoms of preeclampsia, as seen in this patient. The absence of fetal tissue and the ultrasound findings are diagnostic of a complete molar pregnancy.
Explanation for Incorrect Answers:
B. Missed abortion – A missed abortion refers to the death of an embryo or fetus before the 20th week of gestation, with retention of the pregnancy tissue. Ultrasound typically shows a gestational sac with an embryo/fetus lacking cardiac activity, not the characteristic pattern of a molar pregnancy.
C. Ectopic pregnancy – An ectopic pregnancy occurs when a fertilized egg implants outside the uterine cavity, often in a fallopian tube. Ultrasound findings usually include an empty uterus and an adnexal mass, distinct from the findings in molar pregnancy.
D. Normal pregnancy at 8 weeks gestation – A normal pregnancy at 8 weeks would typically show a gestational sac with a developing embryo and cardiac activity on ultrasound, not the pattern seen in molar pregnancies.
E. Partial hydatidiform mole – A partial hydatidiform mole occurs when two sperm fertilize a normal egg, leading to a pregnancy with some normal placental tissue and fetal development but also with molar growth. Ultrasound may show a combination of normal and abnormal tissue, including a fetus with congenital abnormalities, which differs from the complete absence of fetal tissue in a complete mole.
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