DSSSB 14 August 2024
Obstetrics & Gynaecology
Easy
A method of operative treatment for habitual abortions in the second trimester of pregnancy is called:
Appeared in: DSSSB 14 August 2024
Explanation
- The Shirodkar operation is a type of cervical cerclage, a surgical procedure specifically designed to treat cervical incompetence.
- Cervical incompetence is a condition where the cervix is weak and dilates prematurely without contractions, leading to recurrent pregnancy loss, typically in the second trimester.
- The procedure involves placing a non-absorbable purse-string suture high around the cervix to provide structural support and keep it closed throughout the pregnancy.
- This intervention helps to carry the pregnancy to a viable gestational age, preventing miscarriage or premature birth due to cervical weakness.
Why Other Options Were Wrong
- Option A: Nissen's fundoplication is a gastrointestinal surgery, not an obstetric procedure.
- Option B: Waterson's operation is a pediatric cardiac surgery, unrelated to pregnancy or abortion.
- Option C: Potts shunt operation is also a pediatric cardiac surgery, not an obstetric procedure.
Related Visual
Clinical Relevance
- Nursing practice connection: Knowing Surgical management of cervical incompetence for the prevention of recurrent second-trimester pregnancy loss helps nurses interpret findings accurately and avoid errors in routine assessment, medication administration, and patient teaching.
- Nurses play a crucial role in identifying patients at risk for cervical incompetence based on their obstetric history (e.g., prior painless second-trimester losses).
- Post-procedure, vigilant nursing monitoring is essential to detect signs of preterm labor, rupture of membranes, or infection (chorioamnionitis), which are potential complications of cerclage.
- Patient education is a key nursing responsibility, focusing on activity restrictions (pelvic rest), hygiene, and recognizing warning signs (contractions, bleeding, fluid leakage) that require immediate medical attention.
How to Approach the Question
- First, identify the key concepts in the question: 'habitual abortions', 'second trimester', and 'operative treatment'.
- Recognize that this combination of terms points specifically to the clinical problem of cervical incompetence, where the cervix is too weak to stay closed as the pregnancy progresses.
- Next, recall or deduce the name of the surgical procedure used to correct this problem. The goal is to find an obstetric procedure among the options.
- Evaluate each option. Nissen's fundoplication (GI surgery), Waterson's operation (cardiac surgery), and Potts shunt (cardiac surgery) are from different medical specialties and can be eliminated.
- Identify the Shirodkar operation as the correct obstetric procedure designed to reinforce a weak cervix, thereby matching the clinical scenario described in the question.
Concept Tested & Keywords
- Concept Tested: Surgical management of cervical incompetence for the prevention of recurrent second-trimester pregnancy loss.
- Stem keywords: operative treatment, habitual abortions, second trimester
- Lead-in keywords: is called
Question ID
Qo7Ck3FX7cedonm3IqZp-q
Reference Book
E6 Obstetrics Williams p. 8-20
E6 Midwifery Obstetrics and Gynecology Nursing Sandeep Kaur p. 35-43
Practise the full DSSSB 14 August 2024
Attempt every question from this paper in a timed mock, then review the full solution for each one.
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