Which of the following fetal/neonatal complication is associated with hypertensive disorder during pregnancy?… - RRB Nsg. Superintendent -29 April-2025 (shift-2nd)

RRB Nsg. Superintendent -29 April-2025 (shift-2nd)

Obstetrics & Gynaecology

Medium

Appeared in: RRB Nsg. Superintendent -29 April-2025 (shift-2nd)

Explanation

Hypertensive disorders in pregnancy cause vasoconstriction and damage to the maternal spiral arteries that supply the placenta.
This leads to reduced uteroplacental perfusion, a condition known as placental insufficiency.
The diminished supply of oxygen and nutrients to the fetus impairs its ability to grow at a normal rate.
This failure to achieve expected growth potential is defined as Intrauterine Growth Restriction (IUGR).

Option A: This is a classic complication of maternal diabetes, where fetal hyperinsulinemia interferes with cortisol-mediated surfactant production.
Option B: This is not a recognized complication of maternal hypertension. Neonatal hypocalcemia, not hypercalcemia, can be associated with conditions like prematurity or in infants of diabetic mothers.
Option C: Macrosomia (a large baby) is the opposite of what occurs with placental insufficiency caused by hypertension. It is a hallmark of maternal diabetes.

Visual 1: Diagram - Pathophysiology of IUGR. A flowchart showing how maternal hypertension leads to vasoconstriction, reduced placental blood flow, decreased nutrient/oxygen transfer, and ultimately, fetal growth restriction.
Visual 2: Growth Chart - A visual comparison of a normal fetal growth curve versus a growth curve for a fetus with IUGR, demonstrating the deviation from the expected percentile over time.

Clinical Relevance

Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Fetal complications of maternal hypertensive disorders as background academic context rather than a clinical decision trigger.
Nurses play a critical role in monitoring pregnant women for hypertensive disorders by taking accurate blood pressure readings at every antenatal visit and assessing for other signs of preeclampsia like proteinuria and edema.
In a mother with hypertension, nurses must closely monitor fetal well-being through non-stress tests (NSTs), biophysical profiles (BPPs), and tracking fetal movement counts to detect signs of fetal compromise early.
Patient education is key; nurses should teach the mother about the signs of worsening hypertension (e.g., severe headache, visual changes) and the importance of adherence to prescribed antihypertensive medications.

How to Approach the Question

First, identify the key condition in the question stem: 'hypertensive disorder during pregnancy'.
Next, recall the primary pathophysiological effect of hypertension: vasoconstriction and reduced blood flow through blood vessels.
Apply this concept to the pregnancy context. Hypertension will reduce blood flow to the placenta (uteroplacental insufficiency).
Consider the consequence of reduced placental blood flow for the fetus: a decreased supply of oxygen and nutrients.
Evaluate the options based on this consequence. A lack of nutrients will lead to poor growth. 'Intrauterine growth restriction' is the medical term for this.
Eliminate the other options by linking them to their correct maternal condition. Macrosomia and delayed lung maturation are classic signs of maternal diabetes, the opposite of the growth-restricting effects of hypertension.

Concept Tested & Keywords

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