Negative βhCG and Molar Pregnancy: The Hook Effect

• DOI: 10.20344/amp.8603
• Publication Date: 2017-10-11T07:48:34Z
• Authors: Isabel Lobo Antunes; Joana Curado; Ana Quintas; Alcides Pereira
• Keywords: Molar Pregnancy; Gestational Trophoblastic Disease; Pregnancy test; Hyperemesis gravidarum

Molar pregnancy, included in gestational trophoblastic disease, is a benign pathology with ability to metastasize, usually occurring excessively high βhCG levels. Clinical scenario woman extremes of reproductive age presenting amenorrhoea, pain and vaginal blood loss; signs derived from levels may be present (hyperthyroidism, hyperemesis). Diagnosis based on positive pregnancy test – qualitative urinary test. The limitation this results its inability become presence markedly βhCG, saturating the antigens used known as ‘hook effect’. With widespread use gynaecological ultrasound cases molar have been diagnosed timely fashion. We describe case referred degenerating fibroid, negative Transvaginal was highly suggestive which confirmed quantitative test, allowing for treatment. importance index suspicion tremendous avoid devastating consequences delayed diagnosis.