We report a case of pulmonary embolus which is presumed to have been of trophoblastic tissue in a woman in her second pregnancy who had a hyperactive hydatidiform mole. (The size of the uterus was 27 cm after thirteen weeks of amenorrhoea. The level of urinary H.C.G. was greater than 2 million international units per litre.) One hour after the uterus had been evacuated under chemotherapy a picture of acute dyspnoea appeared, and this made it necessary to transfer the patient to an intensive care unit and to incubate her and ventilate her. The analysis of the blood gas showed desaturation and hypoxaemia leading to a diagnosis of massive pulmonary embolus. These complications were resolved in 72 hours and the levels of H.C.G. went down later under the influence of chemotherapy which was started one month after the evacuation and continued for fourteen weeks (for six weeks after the plasma H.C.G. levels had become negative).
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