UPPSC-2021
Obstetrics & Gynaecology
Easy
In which type of abortion does the cervical OS remain closed and there is no passage of tissue?
Appeared in: UPPSC-2021
Explanation
- A threatened abortion is defined by the presence of vaginal bleeding in the first 20 weeks of pregnancy.
- The key diagnostic criteria are a closed cervical os and no expulsion of fetal or placental tissue.
- Despite the bleeding, the pregnancy is still considered viable and may proceed to term.
- Management focuses on conservative measures like bed rest and pelvic rest to support the continuation of the pregnancy.
Why Other Options Were Wrong
- Option A: In a complete abortion, all products of conception have been expelled from the uterus. The cervical os is typically closed after the tissue has passed, and bleeding has subsided.
- Option B: In an inevitable abortion, the cervical os is dilated (open). While tissue may not have passed yet, the process of abortion has begun and cannot be stopped.
- Option C: In an incomplete abortion, the cervical os is open, and some, but not all, of the products of conception have been passed. There is retained tissue within the uterus.
Related Visual
Clinical Relevance
- Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Classification of Spontaneous Abortion as background academic context rather than a clinical decision trigger.
- Accurate identification of the type of abortion is critical for determining the correct nursing management and patient education. Misclassifying a threatened abortion could lead to inappropriate interventions.
- Nursing care for threatened abortion prioritizes patient safety and emotional well-being. This includes educating the patient on signs of worsening conditions (increased bleeding, severe pain, fever) and providing psychological support during a period of uncertainty.
- What if the patient's cervix was found to be open on examination? If the cervix is open, the diagnosis immediately changes from threatened to either inevitable (if no tissue has passed) or incomplete (if some tissue has passed). The management would then shift from trying to preserve the pregnancy to managing the miscarriage process, which may involve expectant management, medication, or surgical evacuation (D&C).
How to Approach the Question
- First, identify the key clinical signs presented in the question stem: 'cervical OS remain closed' and 'no passage of tissue'.
- Next, recall the definitions of the different types of spontaneous abortion provided in the options.
- Systematically evaluate each option against the key signs. 'Complete abortion' involves passage of all tissue. 'Inevitable abortion' involves an open cervix. 'Incomplete abortion' involves an open cervix and partial passage of tissue.
- The only option that matches the criteria of a closed cervix with no tissue passage is 'Threatened abortion'.
- Confirm this by remembering that a threatened abortion is a risk to the pregnancy, but it has not yet progressed to the point of no return.
Concept Tested & Keywords
- Concept Tested: Classification of Spontaneous Abortion
- Stem keywords: abortion, cervical OS, closed, no passage of tissue
- Lead-in keywords: In which type
- Negative lead-in flag: false
Question ID
Q4MYTJBTpDw4WLxurev_fA
Reference Book
E6 Robert Boland, Marcia L. Verduin - Kaplan and Sadock's Comprehensive Text of Psychiatry-Wolters Kluwer Health (2024) (pp 1-16525 of 16525) p. 8397-8399
E6 Gynecology Williams p. 152-181
E6 Obstetrics Williams p. 3
Practise the full UPPSC-2021
Attempt every question from this paper in a timed mock, then review the full solution for each one.
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