The nurse is preparing to administer methotrexate to the patient. This drug is most often used for which obstetric complication?

A. Chronic Hypertension. Chronic hypertension is diagnosed when a woman has hypertension (≥140/90 mmHg) that was present before pregnancy or develops before 20 weeks gestation. Since this patient has a history of hypertension and is only 16 weeks pregnant, her condition is classified as chronic hypertension rather than pregnancy-related hypertension.

B. This is a normal Blood Pressure. A blood pressure of 169/94 mmHg is not normal. This reading indicates hypertension, which requires monitoring and possible medication adjustments to prevent complications such as preeclampsia or fetal growth restriction.

C. Preeclampsia. Preeclampsia is diagnosed after 20 weeks of gestation and includes hypertension along with signs of organ dysfunction (e.g., proteinuria, liver abnormalities, or neurological symptoms). Since this patient is only 16 weeks pregnant and does not show other preeclampsia symptoms, this diagnosis is incorrect.

D. Pregnancy-induced hypertension. Pregnancy-induced hypertension, also known as gestational hypertension, develops after 20 weeks gestation in women with previously normal blood pressure. Because this patient has a prior history of hypertension and is only 16 weeks pregnant, her condition is classified as chronic hypertension, not pregnancy-induced hypertension.

A. Preterm labor. Methotrexate is not used for preterm labor. Medications such as tocolytics (e.g., nifedipine, magnesium sulfate, or terbutaline) are typically used to delay labor and improve neonatal outcomes, but methotrexate does not serve this purpose.

B. Abruptio placentae. Methotrexate is not indicated for abruptio placentae, which is the premature separation of the placenta from the uterine wall. Management of abruptio placentae focuses on stabilizing the mother, monitoring fetal well-being, and delivering the baby if necessary.

C. Pre-eclampsia. Methotrexate does not treat pre-eclampsia. The management of pre-eclampsia includes antihypertensive medications, magnesium sulfate for seizure prevention, and delivery of the baby when indicated.

D. Unruptured ectopic pregnancy. Methotrexate is the first-line treatment for an unruptured ectopic pregnancy. It works by inhibiting rapidly dividing trophoblastic cells, stopping the growth of the ectopic pregnancy while preserving the fallopian tube. It is only used in stable patients with small, unruptured ectopic pregnancies and no signs of internal bleeding.