Snapshot A 27-year-old female presents to the emergency department at 11 weeks of gestation with 2 days of vaginal bleeding and pelvic pressure, as well as multiple daily episodes of nonbloody, nonbilious emesis over the past week. The patient states the bleeding is like heavy spotting with dark purplish-colored blood. On exam the uterus is larger than expected for gestational age. An ultrasound is performed and shows a snowstorm appearance of the uterus with absence of a fetus. Introduction Overview login to view 6 more bullets Epidemiology login to view 7 more bullets Classification Complete mole login to view 5 more bullets Partial mole login to view 5 more bullets Presentation Symptoms login to view 8 more bullets Physical exam login to view 5 more bullets Imaging Transvaginal ultrasound (TVUS) login to view 11 more bullets Studies ↑ β-hCG (> 100,000 mIU/mL) login to view 1 more bullet Differential Normal pregnancy login to view 4 more bullets Miscarriage login to view 5 more bullets Treatment Medical login to view 5 more bullets Surgical login to view 5 more bullets Follow-up login to view 5 more bullets Complications Choriocarcinoma login to view 4 more bullets Ovarian theca-lutein cysts login to view 4 more bullets Hyperthyroidism Preeclampsia Respiratory distress login to view 1 more bullet