Complications of the last stage of Labour include all EXCEPT?

Appeared in: NIMHANS Nursing Officer - 2019

Explanation

The last (third) stage of labour starts after the baby is born and ends with the delivery of the placenta.
Obstructed labour is a condition where the baby's descent through the birth canal is blocked.
This complication occurs during the first or second stage of labour, before the baby is born.
Since the baby has already been delivered by the third stage, obstructed labour cannot be a complication of this stage.

Option A: Postpartum Haemorrhage (PPH) is a classic and major complication of the third stage of labour, often caused by the uterus failing to contract properly after the placenta is delivered (uterine atony).
Option C: Retained placenta is, by definition, a complication of the third stage. It occurs when the placenta is not expelled within the expected timeframe (usually 30 minutes) after the baby's birth.
Option D: Uterine inversion is a rare but life-threatening complication where the uterus turns inside out. This typically occurs during the third stage, often due to mismanagement such as excessive pulling on the umbilical cord.

Clinical Relevance

Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Complications of the Third Stage of Labour as background academic context rather than a clinical decision trigger.
Understanding the specific complications for each stage of labour is critical for timely recognition and intervention by the nurse.
Active Management of the Third Stage of Labour (AMTSL) is a key evidence-based practice to prevent PPH. It includes administering a uterotonic drug, controlled cord traction, and uterine massage.
A nurse's prompt identification of signs of PPH, retained placenta, or uterine inversion is vital for initiating emergency protocols and saving the mother's life.

How to Approach the Question

First, identify the keyword 'EXCEPT'. This tells you to look for the option that does not fit the condition described in the stem.
Next, define the 'last stage of Labour'. This is the third stage, which occurs from the birth of the baby to the delivery of the placenta.
Evaluate each option based on this definition.
Ask yourself: Does PPH happen after the baby is born? Yes.
Ask yourself: Does a retained placenta happen after the baby is born? Yes.
Ask yourself: Does uterine inversion happen after the baby is born? Yes.

Concept Tested & Keywords

Concept Tested: Complications of the Third Stage of Labour
Stem keywords: Complications, last stage of Labour
Lead-in keywords: EXCEPT
Negative lead-in flag: The question uses the word 'EXCEPT', asking you to find the option that is NOT a complication of the last stage of labour.

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E6 Midwifery Obstetrics and Gynecology Nursing Sandeep Kaur pp. 64-78, 1-5

Practise the full NIMHANS Nursing Officer - 2019

Attempt every question from this paper in a timed mock, then review the full solution for each one.