At 10-weeks gestation, a high-risk multiparous client with a family history of Down syndrome is admitted for observation following a chorionic villi sampling (CVS) procedure. What assessment finding requires immediate intervention?

• A. Uterine cramping.
• B. Abdominal tenderness.
• C. Systolic blood pressure < 100 mmHg.
• D. Intermittent nausea.

Answer: (A)

After chorionic villus sampling, you’re watching for signs of possible complications from the invasive procedure, such as miscarriage or abnormal uterine activity. Uterine cramping in this setting is a red flag because it suggests the uterus may be contracting strongly or reacting to a complication like threatened abortion or a procedural injury. That direct link to ongoing pregnancy viability makes it the finding that requires immediate assessment and intervention, such as rapid evaluation for fetal well-being, bleeding, and possible ultrasound or further monitoring.

Mild abdominal tenderness, intermittent nausea, or even mild changes in blood pressure can occur after CVS without indicating an urgent threat to the pregnancy, whereas cramping that reflects active uterine contraction or distress points to a need for prompt action to protect the pregnancy and maternal health.