Question 148

Question:

A 26-year old G1P0 woman with no past medical history presents at 18-weeks gestation for a routine check up. On physical exam she is hypertensive and has bilateral edema. Urinalysis reveals 3+ proteinuria. What is her most likely diagnosis?

Correct Answer: D.  Hydatidiform Mole

This patient’s hypertension, non-dependent edema, and proteinuria during pregnancy are characteristic of preeclampsia. Preeclampsia before 20-weeks gestation is highly suggestive of a hydatidiform mole. Only seizures would qualify this patient for a diagnosis of eclampsia (A).
Intrauterine growth retardation (IUGR) and polyhydramnios are diagnoses based on ultrasound examination (B and C).
No evidence of elevated glucose or reduced glucose tolerance is provided in the question (E).