All of the following are risk factor for hyperemesis gravidarum in pregnancy except?

PGIMS Rohtak NO - 2017

Obstetrics & Gynaecology

Medium

Appeared in: PGIMS Rohtak NO - 2017

Explanation

Hyperemesis gravidarum (HG) is characterized by severe and persistent nausea and vomiting during pregnancy, leading to weight loss and dehydration.
The option 'Multigravida woman' is the correct answer because being a woman who has had multiple pregnancies is not a risk factor for HG.
Conversely, being a primigravida (a woman in her first pregnancy) is considered a risk factor for developing hyperemesis gravidarum.
The other options listed—multiple pregnancy, familial history, and molar pregnancy—are all well-established risk factors for this condition.

Option A: Multiple pregnancy (e.g., twins, triplets) is a significant risk factor for hyperemesis gravidarum. This is because the larger placental mass produces higher levels of human chorionic gonadotropin (hCG), which is strongly linked to the severity of nausea and vomiting.
Option B: A familial history of hyperemesis gravidarum increases a woman's risk. If a woman's mother or sister experienced HG, she is more likely to develop it, suggesting a genetic predisposition.
Option C: Molar pregnancy (hydatidiform mole) is a strong risk factor for hyperemesis gravidarum. In this condition, abnormal trophoblastic tissue proliferates and produces extremely high levels of hCG, often leading to severe vomiting.

Clinical Relevance

Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Risk Factors for Hyperemesis Gravidarum as background academic context rather than a clinical decision trigger.
Nurses must be able to identify patients at risk for hyperemesis gravidarum to ensure early intervention. Key assessments include monitoring for dehydration, weight loss, ketonuria, and electrolyte imbalances.
Management focuses on rehydration with IV fluids, correcting electrolyte disturbances, providing nutritional support, and administering antiemetics. Patient education on dietary modifications (small, frequent, bland meals) is crucial.
What if? If a patient with suspected hyperemesis gravidarum also presents with a uterus larger than expected for gestational age and markedly elevated hCG levels, the nurse should anticipate a diagnostic workup for a molar pregnancy, as this is a significant underlying cause.

How to Approach the Question

First, identify the core concept of the question, which is the risk factors for hyperemesis gravidarum.
Note the negative framing of the question indicated by the word 'except'. This means you are looking for the option that is NOT a risk factor.
Evaluate each option based on your knowledge of obstetrics. Recall that conditions associated with high levels of hCG are major risk factors.
Analyze Option A (Multiple pregnancy): This leads to higher hCG, so it's a risk factor.
Analyze Option B (Familial history): This suggests a genetic link and is a known risk factor.
Analyze Option C (Molar pregnancy): This causes extremely high hCG levels and is a strong risk factor.

Concept Tested & Keywords

QZs3IUPQPUJ9a6jFjp92M2

E6 Midwifery Obstetrics and Gynecology Nursing Sandeep Kaur p. 2-7