North American Registry of Midwives (NARM) Practice Exam

When preeclampsia develops before 36 weeks, the midwife should monitor for which condition?

1. Gestational diabetes

2. Preeclampsia seizures

3. Intrauterine growth retardation

4. Placenta previa

The correct answer is: Intrauterine growth retardation

When preeclampsia develops before 36 weeks of gestation, the midwife should primarily monitor for intrauterine growth retardation (IUGR). This condition is a significant concern because preeclampsia can lead to placental insufficiency, which in turn affects the growth and development of the fetus. When blood flow to the placenta is compromised due to high blood pressure and other symptoms of preeclampsia, the fetus may not receive adequate nutrients and oxygen, leading to restricted growth. Regular monitoring through ultrasounds and assessments of fetal well-being becomes essential in these cases. Identifying IUGR allows for timely interventions to manage pregnancy and possibly determine an optimal time for delivery to minimize risks to both the mother and the fetus. Other conditions, such as gestational diabetes, preeclampsia seizures, and placenta previa, are not direct consequences of early-onset preeclampsia. While they remain important to monitor in general pregnancy care, they do not specifically correlate with the increased risk of complications stemming from preeclampsia occurring before 36 weeks. Therefore, the focus should be on monitoring the growth of the fetus to ensure that any signs of IUGR are detected early.