NVS Staff Nurse - 2019
Obstetrics & Gynaecology
Easy
Accidental hemorrhage is also known as?
Appeared in: NVS Staff Nurse - 2019
Explanation
- "Accidental hemorrhage" is the classic synonym for abruptio placentae.
- This condition involves the premature separation of a normally implanted placenta from the uterine wall after 20 weeks of gestation.
- The term "accidental" refers to the sudden and unexpected nature of the event, which can be caused by factors like hypertension or trauma.
- The hallmark clinical presentation includes painful vaginal bleeding, a tender and rigid (board-like) uterus, and potential fetal distress, distinguishing it from other causes of antepartum hemorrhage.
Why Other Options Were Wrong
- Option A: Circumvallate placenta is an anatomical abnormality of the placenta where the fetal membranes fold back on themselves. It is a structural variant, not a type of hemorrhage.
- Option C: Vasa praevia is a condition where unprotected fetal blood vessels run across the internal cervical os. Bleeding in vasa praevia is of fetal origin and typically occurs upon rupture of membranes, leading to rapid fetal exsanguination.
- Option D: Placenta praevia is the implantation of the placenta in the lower uterine segment, partially or completely covering the cervical os. It is known as "unavoidable hemorrhage" and characteristically presents with painless, bright-red vaginal bleeding.
Related Visual
Clinical Relevance
- Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Terminology and differentiation of antepartum hemorrhage conditions as background academic context rather than a clinical decision trigger.
- Differentiating between painful bleeding (abruption) and painless bleeding (praevia) is a critical nursing assessment skill in obstetrics, as it dictates immediate management.
- A key nursing action for suspected abruption is to establish two large-bore IV lines for rapid fluid and blood product administration, as hemorrhage can be severe and sometimes concealed.
- A digital vaginal examination is strictly contraindicated in a woman with antepartum hemorrhage until placenta praevia has been ruled out by ultrasound, as it can provoke catastrophic bleeding.
How to Approach the Question
- This is a factual recall question testing knowledge of obstetric terminology.
- Identify the key term in the question: 'Accidental hemorrhage'.
- Recall the different causes of antepartum hemorrhage and their associated synonyms.
- Associate 'accidental' with the sudden, often unexpected, separation of the placenta, which is the definition of abruptio placentae.
- Contrast this with 'unavoidable' hemorrhage, the term for placenta praevia, where bleeding is inevitable as the cervix dilates.
- Eliminate the other options: vasa praevia (fetal vessel bleeding) and circumvallate placenta (a placental anomaly).
Concept Tested & Keywords
- Concept Tested: Terminology and differentiation of antepartum hemorrhage conditions.
- Stem keywords: Accidental hemorrhage
- Lead-in keywords: also known as
- Negative lead-in flag: false
Question ID
QCUWnKsVj3g20Af51jypWY
Reference Book
E6 Obstetrics Williams p. 63-85
E6 Midwifery Obstetrics and Gynecology Nursing Sandeep Kaur p. 19-27
Practise the full NVS Staff Nurse - 2019
Attempt every question from this paper in a timed mock, then review the full solution for each one.
More Antepartum Hemorrhage Questions
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