Background: Introduction: It is often difficult to diagnose choriocarcinoma on live pregnancy since it is not based on changes in blood hCG concentration. Genetic and histopathologic tests are the only two methods to determine diagnosis.

Observation: A clinical case is reported on a pregnant woman aged 25 years, of nulligravida, 27-week gestation, and admitted into Gia Lai Hospital in a scenario of intra-abdominal hemorrhage due to a tumor rupture at the left corner of uterine fundus. The patient had a surgery to stop bleeding and excise the tumor for histopathologic testing. The test result was placental choriocarcinoma and the patient was referred to Tu Du Hospital. The patient’s blood beta-hCG was 92.715 mIU/mL. Clinical examination, chest X-ray and MRI scan found the tumor was still localized in the uterine fundus. The patient’s treatment was delayed for 48 hours and cesarean section was made at 28-week and four-day gestation. The newborn’s health was good.

Discussion: Facing a case with abnormal bleeding during pregnancy, we have to careful rule out choriocarcinoma on live pregnancy.