Negative βhCG and Molar Pregnancy: The Hook Effect

Molar pregnancy with false negative urine hCG: the hook effect.

Urine pregnancy tests are widely used in emergency departments as the first screening test for patients of reproductive age presenting with gynaecological problems in order to rule out pregnancy. Conditions such as complete molar pregnancy, which produces large amounts of beta human chorionic gonadotropin (beta-hCG), may cause a false negative result due to an oversaturation of the assay system...

The “hook effect” causing a negative pregnancy test in a patient with an advanced molar pregnancy

•At high hCG levels in molar pregnancies, a "hook effect" can cause an artificially negative value.•Delay in diagnosis of a molar pregnancy due to the "hook effect" can lead to severe complications.•Suspicion of a molar pregnancy should be communicated so a diluted sample is used to quantify hCG.

Compare clinical Presentation of complete Molar Pregnancy and partial Molar Pregnancy ( 2006-2018)

Objective: Molar pregnancy is classified as one of the diseases groups as a type of  Gestational Trophoblastic Disease (GTD) which is emerged from placenta. Hydatitiform moles are diagnosed one per 1500-2000 pregnancies in the United States. There seems to be a large variation in mole development and its frequency in Far East Asia is higher than western industrial. Mole is divided into two ty...

Molar Pregnancy Presents as Tubal Ectopic Pregnancy

Molar Pregnancy

Figure. A transabdominal ultrasound of the pelvis revealing a uterus (arrow) with multiple cystic areas within an enlarged echogenic endometrial cavity (arrowhead). A 15-year-old Hispanic primigravid female at 12 weeks gestation presented to the Emergency Department (ED) complaining of vaginal bleeding for two days. The patient denied any abdominal pain, nausea, vomiting, or fever. On physical ...