Obstetrics and Gynaecologycommon
A 26-year-old primigravida presents at 11 weeks gestation by dates with two weeks of persistent vomiting and one day of light vaginal bleeding. Her blood pressure is 146/94 mmHg and the uterine fundus is palpable at the level of the umbilicus. Serum beta-hCG is 620,000 IU/L, far above the expected range for her dates. Transvaginal ultrasound shows the uterine cavity filled with echogenic tissue containing numerous small cystic spaces, no fetal pole, and enlarged multicystic ovaries bilaterally. Which one of the following is the most likely diagnosis?