JIPMER Nursing Officer-2024
Obstetrics & Gynaecology
Easy
The most common cause of Postpartum Hemorrhage (PPH) is?
Appeared in: JIPMER Nursing Officer-2024
Explanation
- Uterine atony is the failure of the myometrium (uterine muscle) to contract effectively after the delivery of the placenta.
- After delivery, firm uterine contraction is essential to compress the open blood vessels at the former placental implantation site to prevent excessive bleeding.
- When the uterus is atonic (lacks tone), these vessels remain open, leading to rapid and significant blood loss.
- It is the most frequent cause of PPH, responsible for approximately 70-80% of all cases, and is categorized as the 'Tone' component in the '4 Ts' mnemonic.
Why Other Options Were Wrong
- Option B: Placenta previa is a condition where the placenta implants over or near the cervical os. It is a primary cause of antepartum (before birth) hemorrhage, not the most common cause of postpartum hemorrhage.
- Option C: A cervical tear is a form of genital tract trauma. While it can cause significant postpartum bleeding, it is far less common than uterine atony. The key clinical sign is persistent bright red bleeding despite a firm, well-contracted uterus.
- Option D: Retained placenta (or placental fragments) falls under the 'Tissue' category of PPH causes. It prevents the uterus from contracting fully, but it is not as common as primary uterine atony for causing immediate PPH.
Related Visual
- Visual 1: Infographic: The '4 Ts' of Postpartum Hemorrhage (Tone, Trauma, Tissue, Thrombin), illustrating each category with a simple icon and a brief description.
- Visual 2: Illustration: A side-by-side comparison showing a firm, contracted postpartum uterus with compressed blood vessels versus a boggy, atonic uterus with open, bleeding vessels.
Clinical Relevance
- Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Etiology of Postpartum Hemorrhage (PPH) as background academic context rather than a clinical decision trigger.
- The nurse's primary role in preventing PPH is vigilant postpartum assessment, including frequent checks of uterine fundal height, position, and tone.
- A soft, boggy uterus requires immediate intervention, starting with vigorous fundal massage to stimulate contraction while simultaneously calling for help.
- Nurses are responsible for administering uterotonic medications as ordered and monitoring for their effectiveness and side effects.
How to Approach the Question
- This is a factual recall question that tests your knowledge of obstetrical emergencies.
- Identify the core concept from the stem: 'most common cause' of 'Postpartum Hemorrhage (PPH)'.
- Recall the major causes of PPH, often organized by the '4 Ts' mnemonic: Tone, Trauma, Tissue, and Thrombin.
- Remember the relative frequency of these causes. Uterine atony (Tone) is by far the most prevalent.
- Evaluate the given options: 'Atonic uterus' directly corresponds to the 'Tone' category. 'Cervical tear' is 'Trauma', and 'Retained placenta' is 'Tissue'. 'Placenta previa' is primarily an antepartum issue.
- Select the option that represents the most common cause, which is atonic uterus.
Concept Tested & Keywords
- Concept Tested: Etiology of Postpartum Hemorrhage (PPH)
- Stem keywords: Postpartum Hemorrhage, PPH, most common cause
- Lead-in keywords: most common
- Clinical cues: Age/sex group narrows the expected diagnosis, intervention, or normal reference range.
Question ID
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Practise the full JIPMER Nursing Officer-2024
Attempt every question from this paper in a timed mock, then review the full solution for each one.
More Complications of the Third Stage of Labor Questions
- Post-partum women having bleeding within 24 hrs after delivery is called:
- Which of the following drug is preferrably administered immediately after delivery of baby?
- How is blood loss measured in Post-partum hemorrhage?
- Which of the following medication is used in PPH (Post-Partum Hemorrhage)?
- Duration of secondary PPH?
- The nurse in the postpartum unit is caring for a client who has just delivered a newborn infant following a pregnancy with placenta previa. The nurse…
- What nursing interventions should be performed during uterine Fundus Examination after post partum?
- Post-partum women having bleeding from 1st day after delivery is called as?
- The condition where the uterus turns inside out is called?
- Postpartum haemorrhage is the condition in which there is loss of more than ml vaginal blood?
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