North American Registry of Midwives (NARM) Practice Exam

What physical sign may indicate the onset of a seizure in pregnancy?

1. Headache

2. Epigastric pain

3. Shortness of breath

4. Nausea

The correct answer is: Epigastric pain

The indication of the onset of a seizure during pregnancy can formally be associated with specific physical signs. In this context, epigastric pain may be notable as it can precede or accompany certain neurological events, including seizures. During pregnancy, especially in conditions such as preeclampsia, epigastric pain may arise from increased intra-abdominal pressure or issues related to the liver or other organ systems that can affect neurological function. While headaches can also be a symptom related to various pregnancy complications and are common in general, they aren’t as specifically linked to seizures as epigastric pain can be when considering the nuances of pregnancy-related conditions such as eclampsia or preeclampsia. Shortness of breath, while an important symptom, is more associated with respiratory issues, and nausea can occur in many instances during pregnancy without indicating a neurological event. Understanding the distinction and recognizing epigastric pain as a possible trigger or sign helps reinforce the clinical importance for healthcare providers monitoring pregnant individuals, especially those at risk for seizures.