Robert sign is found in?

Appeared in: RUHS, Jaipur, M.Sc Nursing Entrance Exam-2019

Explanation

Robert sign is a specific radiological finding associated with Intrauterine Fetal Death (IUFD).
It is defined as the presence of gas bubbles in the fetal heart and major blood vessels.
The gas is a product of anaerobic bacterial decomposition of fetal tissues after death.
This sign is an early indicator, often visible on an X-ray or ultrasound as early as 12 hours after fetal demise.

Option A: Placenta previa is a condition of abnormal placental implantation in the lower uterine segment. Its hallmark sign is painless vaginal bleeding in the third trimester.
Option B: Abruptio placenta is the premature separation of the placenta from the uterine wall. It typically presents with painful vaginal bleeding, uterine tenderness, and signs of fetal distress.
Option D: A hydatidiform mole is a gestational trophoblastic disease characterized by abnormal proliferation of trophoblastic tissue, often described as a 'grape-like' cluster. There is no viable fetus, so signs of fetal death are not applicable.

Clinical Relevance

Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Radiological signs of Intrauterine Fetal Death (IUFD) as background academic context rather than a clinical decision trigger.
The diagnosis of IUFD is a devastating event for the family. The nurse's primary role is to provide compassionate, empathetic emotional and psychological support to the grieving parents and family.
A critical nursing responsibility is to monitor the mother for complications, especially if the deceased fetus is retained for more than 3-4 weeks. The release of thromboplastin from the decomposing fetus and placenta can lead to Disseminated Intravascular Coagulation (DIC).
Monitoring includes observing for signs of abnormal bleeding (e.g., from gums, IV sites) and checking coagulation studies, such as fibrinogen levels, platelet count, and prothrombin time (PT).

How to Approach the Question

First, identify the key term in the question, which is 'Robert sign'.
This is a factual recall question. Access your knowledge base about specific signs in obstetrics.
Recall the definition of Robert sign: gas in the fetal heart and great vessels.
Associate this sign with the underlying pathology, which is decomposition following fetal death.
Evaluate the options provided. 'IUFD' (Intrauterine Fetal Death) is the condition where fetal decomposition occurs.
Eliminate the other options: Placenta previa and Abruptio placenta are bleeding disorders, and Hydatidiform mole involves abnormal tissue growth, not a fetus.

Concept Tested & Keywords

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