Carneous mole in a depressed patient: a diagnostic dilemma
DOI:
https://doi.org/10.18203/2320-1770.ijrcog20173514Keywords:
Carneous mole, Depression, Selective serotonin reuptake inhibitorAbstract
Carneous mole is a pathological variant of missed abortion of a fetus less than 12 weeks. It’s medically managed by giving repeated doses of misoprostol with or without dilatation and curettage. Due to ambiguity in diagnosis and misleading clinical examination and investigations, surgical exploration was considered as the best approach. The case of carneous mole with depression is reported because of its rarity; as in this case, ammenorrhea was the only presenting complaint and all other laboratory tests, investigations and radiological report failed to detect carneous mole, which was diagnosed incidentally on exploratory laparotomy.
References
Marcus SM. Depression during pregnancy: rates, risks and consequences-mother risk update 2008. Canadian J Clin Pharm. 2009;16(1):e15-e22.
McElhatton PR. Pregnancy: General principles of drug use in pregnancy. Pharm J. 2003;270:232-4.
Riggin L, Frankel Z, Moretti M, Pupco A, Koren G. The fetal safety of fluoxetine: a systemic review and meta-analysis. J Obstet Gynaecol Can. 2013;35:362-9.
Gentile S. Tricyclic antidepressants in pregnancy and peurperium. Expert Opin Drug Saf. 2014;13:207-25.
Hemels ME, Einarson A, Koren G, Lanctot KL, Einarson TR. Antidepressant use during pregnancy and the rates of spontaneous abortion: a meta-analysis. Ann Pharmacother. 2005;39:803-9.
Nakhai-Pour HR, Broy P, Berard A. Use of antidepressants during pregnancy and the risk of spontaneous abortion. CMAJ : Canadian Medical Association Journal. 2010;182(10):1031-7.
Petersen I, Gilbert RE, Evans SJ, Man SL, Nazareth I. Pregnancy as a major determinant for discontinuation of antidepressants: an analysis of data from the Health Improvement Network. J Clin Psychiatry. 2011;72:979-85.
Lupattelli A, Spigset O, Koren G, Nordeng H. Risk of vaginal bleeding and postpartum hemorrhage after use of antidepressants in pregnancy: a study from the Norwegian Mother and Child Cohort Study. J Clin Psychopharmacol. 2014;34:143-8.
Dutta DC. DC Dutta’s Textbook of Obstetrics, Hiralal Konar (editor).7th ed. Kolkata: New Centre Book Agency Pvt Ltd;2011:163-4.
Shanklin D R and Scott J S. Massive subchorial thrombohaematoma (BREUS' MOLE). BJOG: Int J Obstet Gynaecol. 1975;82:476-87.
American Psychiatric Association. Diagnostic and Statistical manual of mental disorders (DSM-5), 5th ed. Arlington, VA: American Psychiatric Association. Washington DC;2013.
Beck AT, Ward CH, Mendelson M, Mock J and Erbaugh J. An inventory for measuring depression. Arch Gen Psychiatry. 1961;4:561-71.
Kroenke K, Spitzer RL. The PHQ-9: A New Depression Diagnostic and Severity Measure. Psychiatr Annals. 2002;32:1-7.
Beck AT, Kovacs M and Weissman A. Assessment of suicide intention: The scale ideation. J Consul Clin Psychol.1979;47:343-52.
Beneke M, Rasmus W. Clinical global impressions (ECDEU): some critical comments. Pharmacopsychiatry.1992;25:171-6.
The use of the WHO-UMC system for standardized case causality assessment. Available at http//:www.who-umc.org/Graphics/24734.pdf Accessed on 20th May 2017.
Naranjo CA, Busto U, Sellers EM, Sander P, Ruiz I, Roberts EA et al. A method for estimating the probability of adverse drug reactions. Clin Pharmacol Ther. 1981;30:239-45.
Hart DB. The nature of the tuberose fleshy mole. BJOG: Int J Obstet Gynaecol. 1902;1:479-87.
Casikar I, Bignardi T, Riemke J, Alhamdan D, Condous G. Expectant management of spontaneous first –trimester miscarriage: Prospective validation of the ‘2-week rule’. Ultrasound Obstet Gynecol. 2010;35(2):223-7.
Ngoc NT, Blum J, Westheimer E, Quan TT, Winikoff B. Medical treatment of missed abortion using misoprostol. Int J Gynecol Obstet. 2004;87(2):138-42.
Tanha FD, Feizi M, Shariat M. Sublingual versus vaginal misoprostol for the management of missed abortion. J Obstet Gynecol Res. 2010;36(3):525-32.
Gronlund A, Gronlund L, Clevin L, Andersen B, Palmgren N, Lideegard Q. Management of missed abortion: comparison of medical treatment with either mifepristone + misoprostol or misoprostol alone with surgical evacuation. A multi-center trial in Copenhagen Country, Denmark. Acta Obstet Gynecol Scand. 2002;81(11):1060-5.
Stevens TG. Carneous Mole Retained Fifteen Months in Utero. Proceed Royal Soci Medicine. 1926;19:43.
Yonkers KA, Wisner KL, Stewart DE, et al. The management of depression during pregnancy: a report from the American Psychiatric Association and the American College of Obstetricians and Gynaecologists. Gen Hosp Psychiatry. 2009;31(5):403-13.