Identify the following instrument.

DSSSB 6 September 2024

Obstetrics & Gynaecology

Easy

Appeared in: DSSSB 6 September 2024

Explanation

The instrument shown is a Laminaria tent, identifiable by its thin, stick-like shape with an attached string for removal.
It is a type of hygroscopic dilator made from the dried stems of Laminaria seaweed.
Its primary function is to absorb moisture from the cervix, causing it to swell and gradually dilate the cervical canal over several hours.
This method of cervical ripening is used to prepare the cervix for procedures such as labor induction, D&C, or termination of pregnancy.

Option B: A Drew Smythe catheter is a rigid, curved metal instrument used for performing an amniotomy (artificially rupturing membranes). It does not resemble the dried, stick-like object in the image.
Option C: A Tenaculum is a type of forceps with sharp, hook-like tips used to grasp and hold the cervix steady during gynecological procedures. It is a metallic, pincer-like instrument.
Option D: A mucus sucker, also known as a bulb syringe, is a soft rubber or plastic device used to suction secretions from a newborn's nose and mouth. Its appearance and function are completely different.

Clinical Relevance

Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Identification of Obstetric and Gynecological Instruments as background academic context rather than a clinical decision trigger.
Correct identification of instruments like the Laminaria tent is crucial for patient safety in obstetric and gynecological settings to ensure the right procedure is performed.
Nurses play a key role in preparing the patient for cervical ripening, explaining the procedure, managing pain and discomfort (cramping is common), and monitoring for potential complications such as infection or premature rupture of membranes.
What if? If faster cervical dilation (e.g., in 4-6 hours) were required, a synthetic hygroscopic dilator like Dilapan-S or a pharmacological agent like misoprostol might be chosen over the slower-acting Laminaria tent.

How to Approach the Question

First, carefully examine the image provided. Note the key features: it is a small, dark, rod-shaped object with a string attached to one end.
Consider the function implied by its appearance. A small stick inserted into a body cavity that needs to be retrieved suggests a temporary implant, and the string is for removal.
Evaluate each option against your visual analysis. A 'catheter' is a tube, 'forceps' are pincer-like, and a 'sucker' is a suction device. None of these match the image.
Recall or deduce the function of a 'tent' in a medical context, which often implies something that expands. A Laminaria tent is known to be a cervical dilator that expands as it absorbs fluid.
Conclude that 'Laminaria tent' is the only option that matches both the visual appearance (stick with a string) and the implied function of a temporary, removable dilator.

Concept Tested & Keywords

QFcdvdz1WSxttrt4drdvWe

E6 Gynecology Williams p. 99-127

E6 Midwifery Obstetrics and Gynecology Nursing Sandeep Kaur p. 50-59