North American Registry of Midwives (NARM) Practice Exam

What does a high quantitative hCG level indicate when diagnosing a hydatidiform mole?

1. Normal pregnancy

2. Possible miscarriage

3. Likely presence of a molar pregnancy

4. Absence of pregnancy

The correct answer is: Likely presence of a molar pregnancy

A high quantitative hCG level is a key indicator in the assessment of a hydatidiform mole, which is a type of gestational trophoblastic disease. In a normal pregnancy, hCG levels rise but usually within expected physiological ranges. However, in the case of a molar pregnancy, particularly a complete hydatidiform mole, the levels of hCG can be significantly elevated, often exceeding what is seen in a normal pregnancy. Hydatidiform moles involve abnormal trophoblastic proliferation where the hCG levels can skyrocket due to the overproduction of this hormone by the diseased tissues. Therefore, a notably high quantitative hCG level in a patient raises a strong suspicion for the presence of a molar pregnancy, triggering further diagnostic evaluations such as an ultrasound or other imaging techniques to confirm the diagnosis and differentiate it from other pregnancy complications. In summary, the presence of high quantitative hCG levels is indicative of the likely presence of a molar pregnancy, guiding healthcare providers in the next steps for management and care.