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A 35 yr old woman who is at 16th wk gestation visits the clinic for a routine evaluation. Her pregnancy has been uncomplicated to date. This is her first pregnancy. She has been previously healthy and does not take any medications. On examination, her BP is 160 / 100mmHg. UA reveals 3+ proteinuria. Which of the following is the most likely cause of these findings? A.) Anencephaly B.) Hydatidiform mole C.) Maternal renal disease D.) Neural tube defect E.) Twin gestation What's the answer and why? 
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Answer is C. Can't exactly explain but none of the other answer is correct. This is Preeclempsia.
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alice8
| Forum Guru Topics: 37 Posts: 643
I think this is not preeclempsia,because preeclempsia appears at 3rd trimestr..it sounds me very close to B.) Hydatidiform mole but not sure cause no input is given about uterine size (if bigger than its gestational age or not)
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mjl1717
| Forum Junior  Topics: 964 Posts: 5442
I agree with alice8-hydatiform mole (hydropic changes could be seen in placenta on ultrasound)
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meg
| Forum Guru Topics: 62 Posts: 806
though preeclampsia is technically from 20 weeks, it can appear earlier in 2 conditions- 1) Hydatiform mole 2)multiple pregnancy
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The correct answer is B. The patient is suffering from Preeclampsia, the onset of this condition before the 20th wk of pregnancy is suggestive of a hydatidiform mole.
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meissa
| Forum Newbie Topics: 0 Posts: 20
THIS IS TOUGH CASE:- HYDATIDIFORM MOLE OCCURE IN FREQUENCY OF 1:1500 IN USA. THE AGE IS EITHER BELOW 18 YEARS OLD OR ABOVE 40.YOUR PATIENT IS 35, TAHT IS OK. tHE S&S USUALLY START AT 6-8 WEEKS WITH VAGINAL BLEEDING, THAT OFTEN SEEN IN VIRTUALLY ALL INSTANCES, YOUR PATIENT NEVER HAD VAGINAL BLEEDING FOR 16 WEEKS ( FROM THE HISTORY). OK, PREECLAMSIA INHYDATIDIFORM MOLE IS FREQUENTLY OF THE FULMINATING TYPE, AND IT CAN OCCURES IN THE SECOND TRIMASTER OF PREGNANCY, BUT IT IS UNUSUAL. OK,PREECLAMPSIA BY DEFINITION IS DEFINED AS TRIAD OF 1) HYPERTENSION WHICH THIS PATIENT HAS.2) PROTEINUREA WHICH THIS PATIENT HAS. AND 3)EDEMA WHICH THIS PATIENT DOES NOT HAVE. SO, PREECLAMSIA BY DEFINITION IS R/O, BESIDE THAT PREECLAMPSIA OCCURS AFTER 20TH WEEKS OF GESTATION. OK, HYDATIDIFORM MOLE SEEMS TO BE OUT, PREECLAMPSIA SEEMS TO BE OUT, TWIN GESTATION UNLIKELY FROM THE HISTORY, SO THE HIGH POSIBILITY IS RENAL DISEASE AND THE PATIENT MAY NOT KNEW ABOUT IT BEFOR PREGNANCY. IT GETTING WORSE WITH PREGNANCY AND LEAD TO HYPERTENSION DUE TO DECREASE PERFUSION AND INCREASE OF ANGIOTENSIN 11 WHIS IS VASOCONSTRICTORS. OR SHE MIGHT HAD MILD HYPERTENSION WHICH IS GETTING WORSE WITH PREGNANCY DUE TO INCREASE VOLIUM OF PLASMA AND OTHER FACTORS THAT INCRESE OF BLOOD PREASURE COULD LEAD TO PROTEINUREA. NOW, WHAT IS THE DIFFERENTIAL DIAGNOSIS OF PREECLAMPSIA AND ECLAMPSIA? IT CAN MIMIC AND BE CONFUSE WITH WITH MANY OTHER DISEASE LIKE; CHRONIC HYPERTENSION, CHRONIC RENAL DISEASE, PRIMARY SEIZURE DISORDER, GALLBLADDER AND PANCREATIC DISEASE, IMMUNE AND THROMBOTIC THROMBOCYTOPENIC PURPORA AND HEMOLYTIC UREMIC SYNDROM. URIC ACID VALUE CAN BE VERY HELPFUL IN SUCH SITUATION, BECAUSE HYPERURECEMIA IS VERY UNCOMMON IN PREGNANCY EXCEPT WITH GOUT, RENAL FAILURE, OR PREECLAPSIA. i HOPE THIS INFORMATION IS HELPFUL, YOU CAN PICK AND CHOOSE
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meissa
| Forum Newbie Topics: 0 Posts: 20
tHE CORRECT ANSWER IS MATERNAL RENAL FAILURE. i POSTED A DETAILED EXPLANATION IN THE POTTOM OF THIS PAGE. PLEASE GO BACK AND GIVE YOUR OPENION
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mana70
| Forum Senior Topics: 23 Posts: 107
"meissa" wrote: tHE CORRECT ANSWER IS MATERNAL RENAL FAILURE. i POSTED A DETAILED EXPLANATION IN THE POTTOM OF THIS PAGE. PLEASE GO BACK AND GIVE YOUR OPENION according to goljan it is hydatiform mole. ans B. high BP before 20 week. mana
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