A 32-year-old primigravida is admitted with a diagnosis of ectopic pregnancy. Nursing care is based on the knowledge that:

Choice A reason: Intense abdominal pain is the most prevalent clinical manifestation of abruptio placentae, as it indicates the detachment of the placenta from the uterine wall and the bleeding into the uterine muscle. The pain can be localized or diffuse, and it can be constant or intermittent. The pain can also radiate to the back or the shoulder.

Choice B reason: Cramping is not the most prevalent clinical manifestation of abruptio placentae, as it is not specific to the condition. Cramping can occur in normal pregnancy or in other complications such as preterm labor, infection, or cervical insufficiency.

Choice C reason: Uterine activity is not the most prevalent clinical manifestation of abruptio placentae, as it is not specific to the condition. Uterine activity can occur in normal pregnancy or in other complications such as preterm labor, infection, or placenta previa.

Choice D reason: Bleeding is not the most prevalent clinical manifestation of abruptio placentae, as it may or may not be present. Bleeding can be concealed or revealed, depending on the location and extent of the placental separation. Concealed bleeding occurs when the blood is trapped behind the placenta and does not exit the vagina. Revealed bleeding occurs when the blood passes through the cervix and exits the vagina.

Choice A reason: Diabetes mellitus is not a direct consequence of inadequate weight gain during pregnancy for the infant. However, maternal diabetes can increase the risk of fetal macrosomia (large birth weight), congenital anomalies, and neonatal hypoglycemia (low blood sugar) in the infant.

Choice B reason: Down syndrome is not a direct consequence of inadequate weight gain during pregnancy for the infant. Down syndrome is a genetic disorder caused by an extra copy of chromosome 21 in the cells of the fetus. The risk of having a baby with Down syndrome increases with maternal age, but it is not related to maternal weight or nutrition².

Choice C reason: Spina bifida is not a direct consequence of inadequate weight gain during pregnancy for the infant. Spina bifida is a neural tube defect that occurs when the spine and spinal cord do not form properly in the fetus. The main risk factor for spina bifida is a lack of folic acid (a B vitamin) in the mother's diet before and during pregnancy.

Choice D reason: Intrauterine growth restriction (IUGR) is a condition in which the fetus does not grow as expected and has a low birth weight. IUGR can have many causes, such as placental problems, infections, chromosomal abnormalities, and maternal factors. One of the maternal factors that can contribute to IUGR is inadequate weight gain during pregnancy, especially in underweight women. IUGR can increase the risk of complications for the infant, such as preterm birth, low Apgar score, hypothermia, hypoglycemia, and breathing problems⁵.