Invasive mole is a condition where the trophoblastic tumour invades the myometrium that may erode into the uterine vessels, causing massive intraperitoneal haemorrhage. Normally it gets detected by ultrasonography, confirmed by raised beta-hCG levels and patient also presents with bleeding per vaginum or pain lower abdomen. Sometimes it goes undetected and can present with silent perforating mole. Here, we report a case of invasive hydatidiform mole presenting as an acute primary haemoperitoneum. The patient presented in emergency with acute abdominal pain, vomiting and signs of haemoperitoneum. Following resuscitation, emergency laparotomy was done which revealed a molar pregnancy perforating through the posterior surface of uterus, resulting in massive haemoperitoneum. For this intractable bleeding, lifesaving hysterectomy was done and patient’s life was saved. The serum beta chorionic gonadotropin (ß-hCG) levels decreased spontaneously following evacuation of the molar pregnancy.

Keywords: Molar pregnancy, Invasive mole, haemoperitoneum