During Artificial Rupture of Membranes or amniotomy in a patient with polyhydramnios, which of the following practices should be strictly avoided?

Appeared in: NORCET-11 Prelims

Explanation

Uncontrolled, rapid drainage of liquor can cause sudden uterine decompression.
Sudden decompression increases risk of cord prolapse, placental abruption, and fetal distress.
Controlled, gradual drainage is the recommended practice to minimize these risks.
Continuous monitoring for cord prolapse and fetal heart rate is essential for safety.
Key differentiator: Only rapid, uncontrolled drainage is harmful; others are standard safety measures.

Option B: Controlled, gradual drainage of liquor is the recommended practice to prevent complications in polyhydramnios.
Option C: Continuous assessment for cord prolapse is a critical safety measure during and after amniotomy, especially in polyhydramnios.
Option D: Assessment of fetal heart rate and maternal blood pressure is essential for monitoring maternal and fetal well-being during the procedure.

Clinical Relevance

Nursing practice connection: Use the key finding related to Safe practice during artificial rupture of membranes in polyhydramnios to guide bedside assessment, documentation, and the next nursing action.
Nurses must ensure slow, controlled drainage of amniotic fluid in polyhydramnios to prevent emergencies.
Immediate recognition and intervention for cord prolapse or placental abruption can save maternal and fetal lives.
What if? If rapid, uncontrolled drainage occurs, the nurse should be prepared for emergency management of cord prolapse or abruption, including immediate delivery if necessary.

How to Approach the Question

Identify the clinical scenario: amniotomy in polyhydramnios.
Recall the complications associated with rapid fluid loss (cord prolapse, abruption).
Eliminate options that are standard safety practices (monitoring, gradual drainage).
Select the option that represents a harmful practice (uncontrolled, rapid drainage).

Concept Tested & Keywords

Concept Tested: Safe practice during artificial rupture of membranes in polyhydramnios
Stem keywords: Artificial Rupture of Membranes, amniotomy, polyhydramnios, practices to avoid
Lead-in keywords: strictly avoided
Clinical cues: polyhydramnios increases risk of cord prolapse and abruption

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E6 Obstetrics Williams p. 27-46

E6 Midwifery Obstetrics and Gynecology Nursing Sandeep Kaur p. 56-70

Practise the full NORCET-11 Prelims

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