An OB nurse is educating a new graduate nurse about the signs and symptoms of a hydatidiform mole.
The new graduate nurse understands the teaching when he identifies the expected assessment findings with this condition.
Which of the following signs and symptoms would the nurse identify?

Choice A rationale

Preeclampsia is concerning but the blood pressure of 138/82 mm Hg is not critically high at this moment. Preeclampsia is diagnosed by new-onset hypertension and proteinuria or significant end-organ dysfunction in the latter half of pregnancy. Immediate intervention isn't necessary unless symptoms worsen.

Choice B rationale

PPROM (Preterm Premature Rupture of Membranes) at 29 weeks gestation with a temperature of 39.1°C (102.3°F) suggests a possible infection which can be life-threatening for both the mother and the fetus. Prompt medical attention is critical to manage the infection and prevent sepsis.

Choice C rationale

Hyperemesis gravidarum, while uncomfortable and requiring intervention, is less immediately threatening compared to a severe infection. It involves excessive vomiting leading to dehydration and weight loss but doesn't pose an acute threat as severe infection does.

Choice D rationale

Placenta previa with no vaginal bleeding for the last 12 hours indicates stability. However, any bleeding during pregnancy can be concerning and needs careful monitoring, but immediate intervention is not as crucial as for an infection.

Choice A rationale

Monochorionic-monoamniotic twins share a single placenta and amniotic sac, increasing the risk for twin to twin transfusion syndrome (TTTS). This condition occurs due to unbalanced blood flow through the shared placenta, leading to discrepancies in blood volume between the twins.

Choice B rationale

TTTS does not result in overperfusion to both babies. Instead, it causes one twin (the donor) to become underperfused, leading to anemia and growth restriction, while the other twin (the recipient) becomes overperfused, causing polycythemia and circulatory overload, which can lead to heart failure.

Choice C rationale

TTTS is not very common in all multiple gestation pregnancies; it primarily affects monochorionic twins. In dichorionic twins, each twin has its own placenta, making TTTS highly unlikely.

Choice D rationale

Monochorionic twins sharing a placenta actually increases their risk for TTTS, not lowers it. The shared placenta creates a scenario where blood vessels can cross and lead to uneven blood flow between the twins. .