Homs governorate, located in central Syria, remains one of the areas significantly affected by the prolonged crisis. According to UNOCHA assessments, millions of people across Syria continue to require humanitarian assistance, with Homs included among key operational areas for coordinated humanitarian response due to sustained pressure on health services and infrastructure disruption.
Despite its central location and relative accessibility compared to other governorates, the health system in Homs continues to face structural challenges, including uneven service availability, increased demand on primary healthcare and limitations in specialized diagnostic capacity, particularly in reproductive health services.
UN humanitarian reporting also highlights that hostilities and insecurity in parts of Homs and surrounding governorates have periodically disrupted access to healthcare facilities and referral pathways, further increasing reliance on humanitarian medical services. In this context, mobile medical teams (MMTs) play a critical role in ensuring continuity of care, early detection of high-risk conditions and timely referral to secondary and tertiary facilities. It was within this fragile health environment that the case was identified through our mobile team operating in Homs governorate.
A.H. was a 20-year-old married woman from AlBayada neighborhood who had been living with her husband for approximately one year. She had no significant past medical or surgical history. A few months prior to her presentation, she had experienced a pregnancy confirmed by a home pregnancy test, which unfortunately ended in a spontaneous miscarriage approximately two months before her visit to the clinic. She later began experiencing persistent symptoms that prompted her return to care. She reported intermittent spotting after intercourse and ongoing nausea that had not been resolved since the miscarriage. While such symptoms can sometimes be seen during post-miscarriage recovery, their persistence raised concern among the clinical team that an underlying condition might still be present.
The patient described increasing worry about her condition, particularly as her symptoms did not improve over time.
The patient was assessed by International Medical Corps’ Medical Mobile Team (MMT), supported by ECHO, during a consultation visit in AlBayada Neighborhood in Homs. She had a recent history of miscarriage but continued to experience symptoms suggestive of an ongoing pregnancy, which prompted further clinical evaluation.
During assessment, ultrasound imaging revealed an abnormal intrauterine pattern consistent with a suspected molar pregnancy. The examination showed a characteristic “snowstorm” appearance, which is a key sonographic finding strongly suggestive of a complete molar pregnancy and helped confirm the clinical suspicion, as other ultrasound patterns can sometimes be misleading. However, the concurrent urine pregnancy test was negative, this created a diagnostic challenge that required a high level of clinical judgment and careful evaluation. The medical team prioritized clinical findings over the urine test and escalated the case for urgent investigation.
A serum beta-hCG test was requested immediately, and the patient was referred to a government hospital. The results confirmed significantly elevated hormone levels (more than 50,000), consistent with a molar pregnancy. She subsequently underwent uterine evacuation, and samples were sent for histopathological confirmation.
Following treatment, the medical team ensured structured follow-up, including serial beta-hCG monitoring, post-treatment counseling, and continued clinical observation to support recovery and prevent complications.
The case also highlighted important gaps in community awareness around early pregnancy care and follow-up. The patient shared her previous understanding of pregnancy care within her community context:
“I used to think that at the beginning of pregnancy, there was no need to come to the clinic… my mother, my grandmother, and the community all had this habit that you only go to the doctor when it is time to give birth. I had never heard that pregnancy needs monitoring from the beginning, or even about this condition before.” — A.H.
From a clinical perspective, Amal Farkouh, MMT Gynecologist emphasized the seriousness and rarity of the condition, as well as the need for rapid action:
“This is one of the life-threatening conditions that requires fast and effective intervention. These are uncommon pregnancy complications, but they can be significant. It is essentially a case of a pregnancy without a fetus that can potentially turn into a malignant condition if not managed properly.” — Dr. Amal Farkouh
