A 24-year-old woman presents at 12 weeks gestation with first trimester bleeding. Ultrasound shows an enlarged uterus filled with heterogeneous echogenic material containing multiple small cystic spaces, with no foetus identified. Bilateral 5 cm ovarian cysts with multiple thin septations are also seen. What is the most likely diagnosis?

• A Missed abortion with retained products of conception
• B Haematometra
• C Twin pregnancy with one vanishing sac
• D Complete hydatidiform mole ✓

Explanation

The 'snowstorm' or bunch of grapes appearance of multiple small vesicular spaces within an enlarged uterus without a foetus is characteristic of a complete hydatidiform mole. The bilateral multicystic ovarian masses are theca lutein cysts caused by excessive beta-hCG stimulation, which strongly supports molar pregnancy. Retained products lack discrete vesicles, and haematometra appears as fluid rather than echogenic vesicular tissue.

Reference: Williams Obstetrics, 26th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.