Which of the following findings would the nurse interpret as suggesting a diagnosis of gestational trophoblastic disease?
A) Elevated hCG levels, enlarged abdomen, quickening
B) Vaginal bleeding, absence of FHR, decreased hPL levels
C) Visible fetal skeleton on ultrasound, absence of quickening, enlarged abdomen
D) Gestational hypertension, hyperemesis gravidarum, absence of FHR
D
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Gestational trophoblastic disease may be manifested by early development of preeclampsia (gestational hypertension), severe morning sickness due to high hCG levels, and absence of fetal heart rate or activity. There is no fetus, so quickening and evidence of a fetal skeleton would not be seen. The abdominal enlargement is greater than expected for pregnancy dates, but hCG, not hPL, levels are increased.
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