A Rare Complication of Molar Pregnancy: Uterine Perforation With Ileal Incarceration Following Suction Curettage

Complete hydatidiform mole is a rare form of gestational trophoblastic disease associated with markedly elevated β-hCG and abnormal trophoblastic proliferation.Occurring as an uncommon complication of dilation and curettage (D&C), uterine perforation can happen more frequently in pathologically altered uteri as seen in molar pregnancies.We report a 27-year-old female presenting at 7 weeks gestation with vaginal spotting, lower back pain, and significantly elevated β-hCG.Ultrasound findings raised concern for molar pregnancy, and suction D&C was performed without immediate signs of complication.Several hours postprocedure, the patient developed severe abdominal pain and vaginal bleeding.CT imaging demonstrated uterine fundal perforation with herniation of small bowel.Emergent laparotomy revealed 10 cm of ileum incarcerated within the uterine cavity, which was successfully reduced without resection.Pathology confirmed complete hydatidiform mole, and β-hCG normalized within three months.This case highlights uterine perforation with bowel incarceration as a rare but serious complication of D&C in molar pregnancy and underscores the importance of early recognition and prompt surgical management.