Abstract:

Exaggerated placental site (EPS) is a rare benign, non-neoplastic condition characterized by excessive proliferation of implantation site intermediate trophoblasts (ISITs) at the placental implantation site, typically occurring after delivery or abortion. The primary clinical manifestation of patients is persistent unexplained vaginal bleeding. Diagnosis is primarily pathological, with key features showing extensive infiltration of intermediate trophoblast cells into the uterine decidua and smooth muscle tissue. A case of patient with medication abortion and syphilis infection who presented with irregular vaginal bleeding and intermittent lower abdominal pain for 50 days post-abortion was reported. Ultrasound revealed retained products of conception involving the myometrium with rich blood flow signals, along with elevated serum β-human chorionic gonadotropin (β-hCG) levels. The patient underwent hysteroscopic resection of residual conception products under ultrasound guidance. Postoperative pathology confirmed EPS. Follow-up showed normalization of β-hCG levels, resumption of menstruation, and favorable prognosis.

Key words: Abortion, Ultrasonography, Syphilis, Case reports, Exaggerated placental site