Question

a 16-year-old girl in her second trimester is brought to the emergency room with vaginal bleeding. on physical examination, her uterus appears to be large for the gestational age. ultrasound studies do not reveal any fetal parts. endometrial curettage reveals a large amount of blood and grape-like masses of tissue. this condition is the most likely an example of :

complete hydatidiform mole
placenta previa
leiomyoma
placental abruption
partial hydatidiform mole

Explanation:

1. Analyze each option:

• Complete Hydatidiform mole: Presents with uterine enlargement for gestational age, no fetal parts on ultrasound, and "grape - like" tissue (hydropic villi) on curettage, which matches the case description.
• Placenta previa: Is characterized by painless vaginal bleeding, and the placenta is low - lying; there are no grape - like tissues or lack of fetal parts as in this case.
• Leiomyoma: These are uterine fibroids, usually present as solid masses and not associated with grape - like tissues or the gestational - related findings here.
• Placental abruption: Is associated with painful vaginal bleeding, and there is separation of the placenta from the uterine wall, not grape - like tissues.
• Partial Hydatidiform Mole: Usually has some fetal parts or fetal tissue, while in this case, no fetal parts are seen on ultrasound, so it is less likely than complete mole.

Answer:

A. Complete Hydatidiform mole