Daman & Diu Staff Nurse - 2018
Obstetrics & Gynaecology
Easy
In which type of abortions is the fetus dead and retained inside the uterus for a variable period?
Appeared in: Daman & Diu Staff Nurse - 2018
Explanation
- A missed abortion is defined by the death of an embryo or fetus in utero without the expulsion of the products of conception.
- In this condition, the cervix remains closed, and the uterus retains the non-viable pregnancy for a variable period, which can range from days to weeks.
- The diagnosis is typically confirmed by an ultrasound that shows a gestational sac with a fetus but no cardiac activity.
- Symptoms of pregnancy may subside, and the patient might only experience minor spotting or a brownish discharge instead of active bleeding.
Why Other Options Were Wrong
- Option A: In a threatened abortion, the fetus is still alive, and while there is vaginal bleeding, the cervix remains closed. The pregnancy has the potential to continue.
- Option B: An inevitable abortion is characterized by an open cervix, indicating that the process of miscarriage is actively underway and cannot be stopped. The products of conception are in the process of being expelled, not retained.
- Option D: In an incomplete abortion, some of the products of conception have been expelled, but some tissue remains in the uterus. The cervix is typically open. This differs from a missed abortion where the entire products of conception are retained.
Related Visual
Clinical Relevance
- Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Types of Spontaneous Abortion as background academic context rather than a clinical decision trigger.
- Nurses play a crucial role in supporting patients experiencing a missed abortion. This includes providing clear explanations, offering emotional and psychological support for the pregnancy loss, and preparing them for management options like expectant management, medical induction, or surgical evacuation (D&C).
- Monitoring for complications is a key nursing responsibility. This includes observing for signs of infection or excessive bleeding. In cases of prolonged retention, nurses must be aware of the signs of Disseminated Intravascular Coagulation (DIC), such as unusual bleeding from gums, nose, or IV sites, and report them immediately.
- What if? If a patient with a diagnosed missed abortion suddenly develops heavy bleeding and severe cramping, the diagnosis may be changing to an inevitable or incomplete abortion. The nurse's priority would be to assess hemodynamic stability (blood pressure, heart rate), quantify blood loss, and prepare for potential emergency intervention.
How to Approach the Question
- First, break down the question to identify the key defining features. The question asks for the type of abortion where the fetus is (1) dead and (2) retained inside the uterus.
- Next, systematically review the definitions of each option provided.
- Evaluate 'Threatened' abortion: The fetus is alive, so this is incorrect.
- Evaluate 'Inevitable' abortion: The process of expulsion is underway (cervix is open), so the fetus is not being retained for a variable period. This is incorrect.
- Evaluate 'Missed' abortion: The fetus is dead and retained in the uterus with a closed cervix. This matches the question's criteria perfectly.
- Evaluate 'Incomplete' abortion: Some tissue has been expelled, so it's not fully retained. This is incorrect.
Concept Tested & Keywords
- Concept Tested: Types of Spontaneous Abortion
- Stem keywords: abortion, fetus dead, retained, uterus
- Lead-in keywords: In which type
Question ID
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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
Practise the full Daman & Diu Staff Nurse - 2018
Attempt every question from this paper in a timed mock, then review the full solution for each one.
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