Abstract:
Invasive mole is a subtype of Gestational Trophoblastic Neoplasias (GTN), which are rare tumors that constitute almost 1% of gynecological tumors. Invasive mole can present with serious complications like uterine perforation and heamoperitonium. Here I present a case of a women of 27 suffering from invasive mole following the evacuation of molar pregnancy. This was diagnosed by trans vaginal ultrasound and successfully treated with homeopathy.
History of present illness
Patient was suffering with excessive vaginal bleeding after the extraction of molar pregnancy since previous one month. After completion of 1st trimester during her 3rd pregnancy she went for normal routine checkup, where she was diagnosed with molar pregnancy.
Meanwhile she started bleeding with the passage of large clots and she had to go for extraction of molar pregnancy. After that her bleeding didn’t stop and on investigation she was diagnosed with invasive mole.
Investigation- Ultrasound pelvis (Trans-abdominal and trans-vaginal) revealed that there is focal highly vascular lesion in the left lateral wall of the uterus adjacent to the endometrium likely invasive mole.
Past history-
Previous molar pregnancy – she had history of molar pregnancy 8 years ago before first live birth. She went for 2 sessions of chemotherapy.
Family history – No family history of any major illness in family.
Physical generals –
Appetite – low appetite, only one meal per day, maximum 1 chappati.
Thirst – adequate, 7-8 glasses per day.
Aversion – bread
Desire – salt
Urine – normal in frequency and quantity
Stool – normal defecation
Perspiration – scanty
Thermal –chilly patient
Sleep –sound
Dreams – not remembered
Mentals
Patient looked very irritable and was answering slowly. She seemed to talk with someone about her condition.
Menstrual history
– Menses – Earlier it was regular before pregnancy. Excessive menstrual flow from last 15 days after the DNC. Bleeding with passage of clots.
Passage of clots during menses – Leucorrhoea – 2-3 days after menses for 3-4 days.
Obstetric history-
Partial molar pregnancy in 2013 that was terminated before completion of first trimester. 2 consecutive sessions of chemotherapy were given for treatment of molar pregnancy. Delivered a female child in 2015, and a male child in 2018. She had full term normal delivery.
Physical examination –
Weight – 52 kg
Pulse – 78/min
Temperature – 97.60F
Blood pressure – 100/70mmHg
Physical make-up
Height – 5’4’’,
Complexion – fair
Systemic examination –
CVS – NAD
CNS – NAD
Skin – pallor
Respi.- NAD
G.I.T. – NAD
Analysis and evaluation of symptoms
Mental generals –
Depressed
Irritable
Wants to be alone to cry
Physical generals-
Aversion – bread
Craving for salts most of the time
Particulars –
Heavy menstrual bleeding
Lasting for 10-12 days
Passage of clots
Pain in lower abdomen during menses
Weakness due to bleeding
Totality of symptoms –
1.Mind – irritable
2.Mind – Answering- slowly
3.Mind –Speech-slow
4.Mind – Company – desire for
5.Generals – Food and Drinks – bread – aversion
6.Female Genitalia/sex- menses-irregular
7.Female Genitalia/Sex – menses-copious
8.Female Genitalia/ Sex – menses- protracted- ten days – ten to twelve days
9. Female Genitalia/Sex – menses-clotted
10.Abdomen – pain-hypogastrium- menses- during
11. Generals- Weakness- menses – after
After considering all the symptoms and on the basis of totality of case she was prescribed Natrum Mur 200 one dose as a constitutional remedy.
0n 7/12/20
China Q and Trillum Q given for the excessive menstrual flow 10 drops 4 times a day.
On 25/12/20
She reported that bleeding has been reduced markedly and she feels better now. But there is still weakness left. She was prescribed Calc Phos 3x and China Q again to control her weakness.
On 15/1/21
She called and reported that bleeding has been stopped completely but she feels weak and wants to rest all the time. She suffered from migraine from previous 10 days.
4 doses of Spigelia 200 given for her headache and Calcarea phos 3x continued.
On 15/2/21
She reported that there is no bleeding or abdominal pain from last month. She feels much better now. She menstruated normally in this month. But a little weakness is still present. She was prescribed Avena stiva Q for the fatigue.
On 2/3/21
She reported with good health condition. There was no weakness, no vaginal bleeding or pain in body. Her menstruation was normal. She consulted for the suggestion to insertion of intrauterine device to prevent future pregnancies. She was quite in good health condition and she went through this procedure without any other complications.
She was suggested pelvis ultrasound again. She shared report on 6/4/21. There was no mole or mass in the uterus. She was enjoying good health.
Discussion
In this case patient had previous history of invasive mole that was treated with chemotherapy. Now the condition was the same. One dose of constitutional remedy gave her ease and mother tinctures treated hemorrhagic conditions very well. She responded well to homeopathic medicines.
Results
In this case the homeopathic medicine Natrum mur worked well on her condition. China Q and Trillium Q controlled her bleeding and Calcarea phos in lower potency help her to improve anemia.
Before treatment usg report
After Treatment Usg Report
Excellent work