Maternity Nursing Q 170
A client makes a routine visit to the prenatal clinic. Although she is 14 weeks pregnant, the size of her uterus approximates that in an 18- to 20-week pregnancy. Dr. Charles diagnoses gestational trophoblastic disease and orders ultrasonography. The nurse expects ultrasonography to reveal:
A. An empty gestational sac.
B. Grapelike clusters.
C. A severely malformed fetus.
D. An extrauterine pregnancy.
Correct Answer: B. Grapelike clusters.
In a client with gestational trophoblastic disease, an ultrasound performed after the 3rd month shows grapelike clusters of transparent vesicles rather than a fetus. The vesicles contain a clear fluid and may involve all or part of the decidual lining of the uterus. Usually, no embryo (and therefore no fetus) is present because it has been absorbed.
Option A: An anembryonic pregnancy is characterized by a gestational sac that forms and grows while an embryo fails to develop. Etiologies include morphological abnormalities of an embryo that prevents implantation or prevents long term survival of the embryo after implantation; chromosomal abnormalities that collectively include autosomal trisomy, polyploidy, sex chromosomal polysomy, and monosomy X likely represent the most common etiologies for early pregnancy loss; and other genetic and chromosomal abnormalities include translocations, inversions, single-gene perturbations, and placental mosaicism.
Option C: Congenital anomalies are also known as birth defects, congenital disorders or congenital malformations. Congenital anomalies can be defined as structural or functional anomalies (for example, a severely malformed fetus) that occur during intrauterine life and can be identified prenatally, at birth, or sometimes may only be detected later in infancy, such as hearing defects.
Option D: Because there is no fetus, there can be no extrauterine pregnancy. An extrauterine pregnancy is seen with an ectopic pregnancy.