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

SCTIMST Staff Nurse - 2016

Obstetrics & Gynaecology

Easy

Appeared in: SCTIMST Staff Nurse - 2016

Explanation

Being a multigravida woman (having had a previous pregnancy) is not considered a primary risk factor for developing hyperemesis gravidarum.
In contrast, the condition is more frequently observed in primigravida women, those who are pregnant for the first time.
While a history of hyperemesis in a previous pregnancy increases the risk for a multigravida woman, the status of being multigravida alone is not a risk factor.

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 associated with the condition.
Option B: A familial history is a recognized risk factor. Women whose close female relatives (mother or sister) have had hyperemesis gravidarum are at an increased risk, suggesting a genetic component to the condition.
Option C: Molar pregnancy (hydatidiform mole) is a major risk factor. This condition involves abnormal proliferation of trophoblastic tissue and is characterized by pathologically high levels of hCG, which often leads to severe nausea and 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 should be aware of the risk factors for hyperemesis gravidarum to identify at-risk patients early in pregnancy.
Early identification allows for proactive management, including dietary counseling, antiemetic therapy, and monitoring for signs of dehydration and malnutrition, which can prevent severe complications and hospital admission.
What if? If a multigravida patient presents with severe nausea and vomiting, the nurse should not dismiss it. Instead, they should inquire about her history, specifically asking if she had hyperemesis gravidarum in her previous pregnancies, as a prior history is a strong predictor of recurrence.

How to Approach the Question

First, carefully read the question and identify the negative keyword 'except'. This means you are looking for the option that is NOT a risk factor.
Recall the pathophysiology of hyperemesis gravidarum, which is primarily linked to high levels of hCG.
Evaluate each option based on this knowledge. Multiple pregnancies and molar pregnancies are associated with high hCG levels, making them strong risk factors.
Consider the other options. Familial history is a common risk factor for many conditions.
Analyze the term 'multigravida'. Recall that hyperemesis is more common in first-time pregnancies (primigravida). This makes 'multigravida' the logical exception.
Select the option that does not fit the pattern of known risk factors.

Concept Tested & Keywords

Concept Tested: Risk factors for hyperemesis gravidarum
Stem keywords: risk factor, hyperemesis gravidarum, pregnancy
Lead-in keywords: except
Negative lead-in flag: The question asks for the option that is NOT a risk factor.

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E6 Obstetrics Williams p. 37-56