Inpatient Obstetric Nurse (NCC) Practice Exam

Preeclampsia in the first trimester with elevated hCG levels is likely indicative of which condition?

1. Hydatidiform mole

2. Gestational hypertension

3. Chronic hypertension

4. Eclampsia

The correct answer is: Hydatidiform mole

Preeclampsia is typically characterized by hypertension and proteinuria that arises after the 20th week of gestation; however, when it occurs in the first trimester alongside elevated human chorionic gonadotropin (hCG) levels, it is likely suggestive of a hydatidiform mole. This condition, also known as a gestational trophoblastic disease, is associated with abnormal placental development leading to the formation of cystic, swelling structures. The excessively high levels of hCG in the context of early pregnancy can indicate the presence of a hydatidiform mole because these moles have abnormal cellular growth that produces hCG in greater quantities than a normal pregnancy would. In contrast, conditions such as gestational hypertension and chronic hypertension would not typically present with preeclampsia in the first trimester nor are they characterized by elevated hCG levels. Eclampsia, which can be a progression of severe preeclampsia, is not a diagnosis that would be considered in this early stage of pregnancy with the associated symptoms presented. Therefore, the presence of early-onset preeclampsia and high hCG levels points directly towards the likelihood of a hydatidiform mole.