Complete hydatidiform mole with hook effect and severe anemia in 36-week size uterus: A rare case report from India

We present a rare case of a 27-year-old woman with a complete hydatidiform mole, which is an abnormal pregnancy that typically causes vaginal bleeding and elevated serum \(\beta\)-human chorionic gonadotrophin (hCG) levels. However, this patient had a 36-week size uterus, severe anemia, and vaginal bleeding, but with a non-detectable \(\beta\)-hCG level, likely due to the “hook effect.” She also had chronic pancreatitis, with a dilated hepatobiliary system and free fluid in the pelvis, caused by the enlarged uterus compressing the abdominal organs. The patient received blood transfusions and was treated with dilation, evacuation, and serial monitoring of serum \(\beta\)-hCG levels. It is important to note that a negative urine pregnancy test or non-detectable \(\beta\)-hCG level should be followed up with a repeat measurement on a diluted sample to avoid the “hook effect.”