title: Qualitative beta-hCG urine assays may be misleading in the presence of molar pregnancy: a case report.
abstract: Molar pregnancy is a rare complication of pregnancy and the diagnosis is usually confirmed with a markedly elevated beta-hCG and a "snowstorm" appearance on pelvic ultrasound. Patients frequently present with a positive pregnancy test, vaginal bleeding, nausea and vomiting. A 23-year-old woman presented to our Emergency Department with a history of 7 weeks of intermittent vaginal bleeding and 1 h of peri-umbilical abdominal pain. She reported that 7 weeks before this visit she was diagnosed with a miscarriage. The bedside qualitative urine human chorionic gonadotropin (hCG) test that we performed was negative, but the quantitative serum hCG was markedly elevated. Ultrasound and operative findings confirmed the diagnosis of molar pregnancy. We conclude that rapid urine qualitative hCG assays may not be reliable in the presence of markedly elevated hCG levels found in molar pregnancy.
authors.affiliation: Department of Emergency Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.
authors.forename: Chris M
authors.initials: CM
authors.lastname: Davison
authors.forename: Richard M
authors.initials: RM
authors.lastname: Kaplan
authors.forename: Linda N
authors.initials: LN
authors.lastname: Wenig
authors.forename: David
authors.initials: D
authors.lastname: Burmeister
mesh_terms: D015746:Abdominal Pain / Q000209:etiology; D000328:Adult; D018997:Chorionic Gonadotropin, beta Subunit, Human / Q000652:urine*; D004635:Emergency Medicine / Q000379:methods*; D005260:Female; D006801:Humans; D006828:Hydatidiform Mole / Q000150:complications / Q000000981:diagnostic imaging / Q000628:therapy / Q000652:urine*; D009325:Nausea / Q000209:etiology; D009765:Obesity / Q000150:complications; D011237:Predictive Value of Tests; D011247:Pregnancy; D016896:Treatment Outcome; D014463:Ultrasonography; D014592:Uterine Hemorrhage / Q000209:etiology; D014839:Vomiting / Q000209:etiology
chemical_list: D018997:Chorionic Gonadotropin, beta Subunit, Human