AIIMS Raipur - 2017 (shift-2)
Obstetrics & Gynaecology
Medium
The following are the causes of separation of a normally situated placenta, EXCEPT?
Appeared in: AIIMS Raipur - 2017 (shift-2)
Explanation
- Thrombophlebitis is the inflammation of a vein, typically in the legs, associated with a blood clot.
- This condition is a localized inflammatory process and is not recognized as a direct cause of premature placental separation (abruptio placentae).
- It is distinct from thrombophilia, which is a systemic hypercoagulable state (an increased tendency for blood clotting) that IS a known risk factor for placental abruption.
Why Other Options Were Wrong
- Option A: This is a valid cause of placental abruption.
- Option B: This is a primary pathological cause of placental abruption.
- Option C: This is a recognized contributing factor to placental abruption.
Related Visual
- Visual 1: Diagram - An illustration comparing a normal placenta with partial and complete placental abruption, showing both concealed and revealed hemorrhage. This helps visualize the pathology.
- Visual 2: Diagram - A depiction of supine hypotension syndrome, showing the gravid uterus compressing the inferior vena cava and aorta when the mother is lying on her back. This clarifies the mechanism of this distractor.
Clinical Relevance
- Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Etiology of Placental Abruption as background academic context rather than a clinical decision trigger.
- Placental abruption is a life-threatening obstetric emergency. Nurses must be able to rapidly identify its signs and symptoms, which include vaginal bleeding (though it can be concealed), uterine tenderness or rigidity, abdominal or back pain, and signs of fetal distress on the monitor.
- Immediate nursing interventions include establishing large-bore IV access, preparing for potential blood transfusion, continuous fetal monitoring, and notifying the obstetric team urgently.
- What if? - If the patient's history included a thrombophilia (like Factor V Leiden) instead of thrombophlebitis, her risk for placental abruption would be significantly increased. In that case, it would be a relevant risk factor, not an exception.
How to Approach the Question
- First, identify the keyword "EXCEPT." This tells you that three of the options are correct statements (causes of the condition), and one is incorrect (not a cause).
- Next, define the term in the question stem: "separation of a normally situated placenta" is the medical definition of placental abruption (abruptio placentae).
- Systematically evaluate each option. Ask yourself, "Is [option] a known cause or risk factor for placental abruption?"
- Validate Option A (Sudden uterine decompression), Option B (Defective decidua), and Option C (Supine hypotension syndrome) as known causes based on your knowledge of obstetric emergencies.
- Evaluate Option D (Thrombophlebitis). Recognize that this is a localized vein inflammation and is different from thrombophilia (a clotting disorder), which is a risk factor. Since thrombophlebitis is not a direct cause, it is the correct answer.
Concept Tested & Keywords
- Concept Tested: Etiology of Placental Abruption
- Stem keywords: causes, separation, normally situated placenta
- Lead-in keywords: EXCEPT
- Negative lead-in flag: EXCEPT
Question ID
Q4VkLTPTGJxq3U0IBchR8C
Practise the full AIIMS Raipur - 2017 (shift-2)
Attempt every question from this paper in a timed mock, then review the full solution for each one.
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