Term pregnancy with choriocarcinoma presenting as severe fetal anemia and postpartum hemorrhage

• Main Authors: Hsiu-Huei Peng, Zooi-Ping Ng, Yun-Hsin Tang, Angelica Anne A. Chua, Kuan-Gen Huang
• Format: Article
• Language: English
• Published: Elsevier 2016-06-01
• Series: Taiwanese Journal of Obstetrics & Gynecology
• Subjects: fetal anemia; postpartum hemorrhage; term pregnancy with choriocarcinoma
• Online Access: http://www.sciencedirect.com/science/article/pii/S1028455916300432

Objective: Term pregnancy with choriocarcinoma is a rare condition that can be a serious health threat to both the mother and the fetus. We present a rare case of term pregnancy with choriocarcinoma presenting as severe fetal anemia and postpartum hemorrhage. Case Report: A 34-year-old woman, gravida 3 para 2, was admitted for profuse vaginal bleeding 2 weeks after cesarean delivery of a full-term anemic baby. Transvaginal sonography revealed a 4.7-cm × 10.6-cm heterogenous lesion in the endometrial cavity. Dilatation and curettage was done and a pathologic report revealed choriocarcinoma. Metastatic workup showed lung metastasis. The patient achieved remission after eight cycles of chemotherapy in the form of etoposide, methotrexate, actinomycin D, cyclophosphamide, and vincristine. There was no evidence of recurrence in the subsequent 3 years of regular follow up. Conclusion: Although fetomaternal hemorrhage is a rare form of presentation of choriocarcinoma, its presence should alert the physician to investigate the cause further. This chemotherapy regimen was effective in our case and the patient needed to be followed up carefully.