Central Institute of Psychiatry - 9 July 2022
Obstetrics & Gynaecology
Medium
Causes of APH, except?
Appeared in: Central Institute of Psychiatry - 9 July 2022
Explanation
- The correct option is PPH because it is defined as bleeding that occurs after childbirth, making it distinct from antepartum hemorrhage (APH).
- APH specifically refers to bleeding from the genital tract after the 24th week of pregnancy but before the birth of the baby.
- PPH stands for Postpartum Hemorrhage. The prefix 'post-' means 'after', and 'partum' relates to childbirth. Therefore, PPH is bleeding that occurs after delivery.
- Since APH and PPH are defined by their timing relative to birth (before vs. after), PPH cannot be a cause of APH, making it the correct exception.
Why Other Options Were Wrong
- Option A: Abruption placenta (placental abruption) is one of the two most common causes of Antepartum Hemorrhage (APH).
- Option B: Placenta previa is a primary and classic cause of Antepartum Hemorrhage (APH), characterized by the placenta covering the cervical os.
- Option D: This option is incorrect because it groups two valid causes of APH (Abruption placenta and Placenta previa). The question asks for the option that is NOT a cause.
Related Visual
Clinical Relevance
- Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Differentiation between Antepartum Hemorrhage (APH) and Postpartum Hemorrhage (PPH) as background academic context rather than a clinical decision trigger.
- Differentiating between APH and PPH is critical for nurses as the management protocols are entirely different. APH management focuses on maternal and fetal stabilization with potential for emergency delivery, while PPH management focuses on controlling uterine bleeding after delivery.
- A key nursing safety action in suspected APH is to NEVER perform a digital vaginal examination until placenta previa has been ruled out by ultrasound, as it can provoke catastrophic hemorrhage.
- What if? If the patient was bleeding heavily 1 hour after delivery, the diagnosis would shift from APH to primary PPH. The priority nursing interventions would change to uterine massage, administering uterotonics (like oxytocin), assessing for lacerations, and quantifying blood loss, rather than preparing for an emergency delivery.
How to Approach the Question
- First, identify the core concept being tested: the causes of Antepartum Hemorrhage (APH).
- Recognize the negative framing keyword 'EXCEPT'. This signals that you must find the option that does NOT fit the category.
- Define APH in your mind: bleeding from the genital tract after 20-24 weeks of pregnancy but before the baby is born.
- Evaluate each option against this definition.
- Option A, Abruption placenta, is a classic cause of APH. Eliminate it.
- Option B, Placenta previa, is another classic cause of APH. Eliminate it.
Concept Tested & Keywords
- Concept Tested: Differentiation between Antepartum Hemorrhage (APH) and Postpartum Hemorrhage (PPH)
- Stem keywords: Causes, APH, except
- Lead-in keywords: except
- Negative lead-in flag: The question uses the word 'except', asking to identify the option that is NOT a cause of APH.
Question ID
Q4RAfkcnhiT1nhNxFAxdOD
Reference Book
E6 Obstetrics Williams p. 47-67
E6 Midwifery Obstetrics and Gynecology Nursing Sandeep Kaur p. 65-80
Practise the full Central Institute of Psychiatry - 9 July 2022
Attempt every question from this paper in a timed mock, then review the full solution for each one.
More Complications of the Third Stage of Labor Questions
- Post-partum women having bleeding within 24 hrs after delivery is called:
- Which of the following drug is preferrably administered immediately after delivery of baby?
- How is blood loss measured in Post-partum hemorrhage?
- Which of the following medication is used in PPH (Post-Partum Hemorrhage)?
- Duration of secondary PPH?
- The nurse in the postpartum unit is caring for a client who has just delivered a newborn infant following a pregnancy with placenta previa. The nurse…
- What nursing interventions should be performed during uterine Fundus Examination after post partum?
- Post-partum women having bleeding from 1st day after delivery is called as?
- The condition where the uterus turns inside out is called?
- Postpartum haemorrhage is the condition in which there is loss of more than ml vaginal blood?
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