Competing causes of rising hCG .. Molar pregnancy VS Ectopic pregnancy

Molar and ectopic pregnancies are both complications of pregnancy that occur when a fertilized egg doesn’t implant correctly. Even though they might have similarities, they both are totally different in terms of pathophysiology.

Molar pregnancy → Abnormal fertilization, it occurs when sperm fertilizes an empty egg. The placental tissue grows but is abnormal and contains fluid-filled cysts, which leads to tumor formation that can progress to chorionic carcinoma.
With abornmally high hCG and vaginal bleeding in first 3 months of pregnancy, molar pregnancy can complicate to preeclampsia, shock and malignancy.

Ectopic pregnancy → Abnormal implantation, it occurs when normal fertilization happens but outside the uterus, and hence the fertilized egg can’t grow. Ectopic pregnancies can become life-threatening, especially if your fallopian tube breaks, leading to a medical emergency.
This also causes vaginal bleeding however, the blood loss is too high that can cause anemia and fainting. Here, the hCG keeps fluctuating between low, normal, and high ranges.

Sharing the similarities of initial symptoms as lower abdominal pain, vaginal bleeding and missed periods, it also shares the similarities of elevated hCG even though at different point of times.

:butterfly:Now that we know the similarities, what do you think can be the differentiating factors for both the pregnancy complications?? :butterfly:

I personally think the key differences lie in location and lab findings. Molar pregnancy shows abnormally high hCG and a “snowstorm” pattern on ultrasound, while ectopic pregnancy presents with fluctuating hCG and no intrauterine sac. Pain location, bleeding severity, and risk of rupture also help distinguish between the two.

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Good points!

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