North American Registry of Midwives (NARM) Practice Exam

What tests are best for confirming a suspected hydatidiform mole?

1. Urine test and ultrasound

2. Single serum quantitative hCG level and sonogram

3. Complete blood count and Doppler ultrasound

4. Pelvic examination and MRI

The correct answer is: Single serum quantitative hCG level and sonogram

The best tests for confirming a suspected hydatidiform mole are a single serum quantitative hCG level and a sonogram. In cases of molar pregnancies, there is typically an abnormally high level of human chorionic gonadotropin (hCG), which can be detected through quantitative blood testing. This test provides precise quantification of hCG levels, allowing for the identification of significantly elevated values often associated with gestational trophoblastic disease, including hydatidiform moles. A sonogram (ultrasound) is also crucial as it enables visualization of the characteristic findings associated with a molar pregnancy. These findings might include the presence of clusters of cystic structures (resembling a "grape-like" appearance) in the uterus, which can help differentiate between a complete and partial mole. Other testing methods listed, such as urine tests, while useful for initial pregnancy screening, do not provide the specificity and accuracy needed to confirm a hydatidiform mole. Similarly, complete blood counts or imaging like MRI do not provide the needed focus on hCG levels and ultrasound findings that are central to diagnosing this specific condition. Therefore, the combination of a single serum quantitative hCG level and sonogram is the most effective for confirming a suspected hydatid