A cystic degeneration of chorionic villi occurs in?

IGNOU Post B. SC. Nursing entrance -2021

Obstetrics & Gynecology

Easy

Appeared in: IGNOU Post B. SC. Nursing entrance -2021

Explanation

Hydatidiform mole is a form of gestational trophoblastic disease resulting from abnormal fertilization.
Its defining pathological feature is the cystic or hydropic (edematous) swelling of the chorionic villi of the placenta.
This process leads to the formation of a mass of grape-like vesicles that fill the uterine cavity.
The condition is associated with abnormal proliferation of trophoblastic tissue and markedly elevated levels of human chorionic gonadotropin (β-hCG).

Option A: Hyperemesis gravidarum is severe nausea and vomiting during pregnancy. It is a clinical symptom, not the underlying pathology of cystic villi.
Option B: Hydramnios (or polyhydramnios) refers to an excessive volume of amniotic fluid. It is a disorder of amniotic fluid regulation, not a structural abnormality of the placental villi.
Option C: Hypertension is elevated blood pressure. While early-onset preeclampsia (a hypertensive disorder) is a known complication of hydatidiform mole, it is not the primary disease process.

Clinical Relevance

Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Pathophysiology of Gestational Trophoblastic Disease as background academic context rather than a clinical decision trigger.
Nurses play a key role in identifying potential molar pregnancies by assessing for signs like vaginal bleeding, uterine size larger than dates, and severe vomiting.
Post-evacuation management is critical. It involves serial monitoring of serum β-hCG levels to ensure they return to normal, as persistently elevated or rising levels can indicate malignant gestational trophoblastic neoplasia (GTN), such as choriocarcinoma.
Patient education is vital, covering the need for reliable contraception (usually for 6-12 months) to avoid a subsequent pregnancy that would interfere with β-hCG monitoring.

How to Approach the Question

First, analyze the question to identify the core pathological description: 'cystic degeneration of chorionic villi'.
Recall the definitions of common pregnancy-related complications.
Evaluate each option against the key description. Hyperemesis gravidarum is severe vomiting, hydramnios is excess amniotic fluid, and hypertension is high blood pressure. None of these match the description of cystic villi.
Recognize that 'cystic degeneration of chorionic villi' is the hallmark definition of a hydatidiform mole (molar pregnancy).
Select the option that directly corresponds to this pathological definition.

Concept Tested & Keywords

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E6 Midwifery Obstetrics and Gynecology Nursing Sandeep Kaur p. 14-22

E6 Pathology- ROBBINS & COTRAN PATHOLOGIC BASIS OF DISEASE 10TH Ed p. 1033-1035

E6 Obstetrics Williams p. 31-52