Maternity Nursing Q 173
Upon assessment, the nurse found the following: fundus at 2 fingerbreadths above the umbilicus, last menstrual period (LMP) 5 months ago, fetal heartbeat (FHB) not appreciated. Which of the following is the most possible diagnosis of this condition?
A. Hydatidiform mole
B. Missed abortion
C. Pelvic inflammatory disease
D. Ectopic pregnancy
Correct Answer: A. Hydatidiform mole
Hydatidiform mole begins as a pregnancy but early in the development of the embryo degeneration occurs. The proliferation of the vesicle-like substances is rapid causing the uterus to enlarge bigger than the expected size based on ages of gestation (AOG). In the situation given, the pregnancy is only 5 months but the size of the uterus is already above the umbilicus which is compatible with 7 months AOG. Also, no fetal heartbeat is appreciated because the pregnancy degenerated thus there is no appreciable fetal heartbeat.
Option B: A missed abortion is a nonviable intrauterine pregnancy that has been retained within the uterus without spontaneous abortion. Typically, no symptoms exist besides amenorrhea, and the patient finds out that the pregnancy stopped developing earlier when a fetal heartbeat is not observed or heard at the appropriate time. An ultrasound usually confirms the diagnosis.
Option C: Pelvic inflammatory disease (PID) is an infection of one or more of the upper reproductive organs, including the uterus, fallopian tubes, and ovaries. Untreated PID can cause scar tissue and pockets of infected fluid (abscesses) to develop in the reproductive tract, which can cause permanent damage.
Option D: An ectopic pregnancy is when a fertilized egg implants itself outside of the womb, usually in one of the fallopian tubes. The fallopian tubes are the tubes connecting the ovaries to the womb. If an egg gets stuck in them, it won’t develop into a baby and the mother’s health may be at risk if the pregnancy continues.