A woman presents with Molar pregnancy and during antenatal checkup what will be the finding of nurse during v… - NORCET 10 Prelims-2026

NORCET 10 Prelims-2026

Obstetrics and Midwifery Nursing

Easy

Appeared in: NORCET 10 Prelims-2026

Explanation

A molar pregnancy, or hydatidiform mole, is a type of gestational trophoblastic disease characterized by abnormal proliferation of placental trophoblastic tissue.
In this condition, the chorionic villi become edematous and swell, forming clusters of clear, fluid-filled sacs that resemble a 'bunch of grapes'.
The classic and pathognomonic finding during a physical or vaginal examination is vaginal bleeding mixed with the passage of these grape-like vesicles.
This finding is most characteristic of a complete hydatidiform mole.

Option B: This is incorrect because β-hCG levels are characteristically and markedly elevated in complete molar pregnancies, often exceeding 100,000 mIU/mL, due to the over-proliferation of trophoblastic tissue.
Option C: Placenta previa is a separate condition and does not involve the formation of vesicles. Its classic sign is painless, bright red vaginal bleeding.
Option D: Abruptio placenta is an acute obstetric emergency with a different presentation. It does not involve grape-like vesicles.

Visual 1: Gross Specimen - A photograph showing the characteristic 'bunch of grapes' appearance of an evacuated complete hydatidiform mole. This helps learners visualize the key finding described in the correct option.
Visual 2: Ultrasound Image - A transvaginal sonogram displaying the classic 'snowstorm' appearance of a complete mole, with an echogenic uterine mass and multiple anechoic spaces, but no fetus. This illustrates the primary diagnostic imaging finding.

Clinical Relevance

Nursing practice connection: Use the key finding related to Clinical presentation and diagnosis of Molar Pregnancy (Hydatidiform Mole) to guide bedside assessment, documentation, and the next nursing action.
Nurses must monitor patients with a suspected molar pregnancy for signs of hemorrhage and shock, as bleeding can be profuse. Ensuring IV access and availability of blood products is a priority.
Post-evacuation follow-up is critical. Serial β-hCG monitoring is required to detect persistent gestational trophoblastic neoplasia (GTN), a malignant complication. A rise or plateau in hCG levels indicates malignancy.
Patient education on the need for reliable contraception (usually for 6-12 months) is a key nursing role. This ensures that hCG levels can be accurately monitored for cancer surveillance without being confounded by a new pregnancy.

How to Approach the Question

First, identify the core concept of the question, which is 'Molar pregnancy'.
Recall the pathognomonic (classic, defining) signs and symptoms associated with this condition.
Analyze the options provided. The phrase 'grapes like vesicles' is a very specific and strong keyword directly linked to the gross appearance of a hydatidiform mole.
Systematically eliminate the other options by identifying them as separate, distinct pregnancy complications with different hallmark presentations.
Recognize that 'Decreased β-Hcg' is the opposite of what occurs in a complete mole.
Differentiate the bleeding patterns: 'Placenta previa' is typically painless, and 'Abruptio placenta' is typically painful, whereas molar pregnancy is characterized by the unique passage of vesicular tissue.

Concept Tested & Keywords

Concept Tested: Clinical presentation and diagnosis of Molar Pregnancy (Hydatidiform Mole)
Stem keywords: Molar pregnancy, antenatal checkup, vaginal examination
Lead-in keywords: what will be the finding

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