IGNOU Post B. SC. Nursing entrance -2021
Obstetrics & Gynaecology
Medium
The safest method of termination of pregnancy before 12 weeks is?
Appeared in: IGNOU Post B. SC. Nursing entrance -2021
Explanation
- Dilatation and Curettage (D&C) is a surgical procedure used to remove tissue from inside the uterus.
- For first-trimester pregnancy termination (before 12 weeks), it is a highly effective and safe method when performed by a trained provider.
- Compared to the other options, D&C offers a definitive, one-time procedure with a high success rate (over 99%) and a lower risk of complications like incomplete abortion.
- While suction aspiration is now more common, D&C is the correct surgical choice among the given options.
Why Other Options Were Wrong
- Option A: The uterus has a very low concentration of oxytocin receptors in the first trimester, making it resistant to the effects of oxytocin. Therefore, administering oxytocin is ineffective for inducing an abortion at this stage.
- Option B: A laminaria tent is not a method of termination. It is a tool used for cervical preparation. It is made of dried seaweed that absorbs moisture and swells, gradually dilating the cervix.
- Option D: While prostaglandins (like misoprostol) are used for medical abortion, using them alone in the first trimester is associated with higher rates of failure, incomplete abortion, and significant side effects such as heavy bleeding and severe cramping compared to surgical methods.
Related Visual
Clinical Relevance
- Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Safest method for first-trimester pregnancy termination as background academic context rather than a clinical decision trigger.
- A nurse's primary role is to provide unbiased, evidence-based information and counseling to patients considering pregnancy termination, ensuring they understand all options, benefits, and risks.
- Post-procedure nursing care involves monitoring for signs of complications such as excessive bleeding (soaking more than two pads per hour), fever, severe pain not relieved by medication, or foul-smelling discharge, and educating the patient on when to seek immediate medical attention.
- Nurses must also provide emotional support and information on post-abortal contraception, which can be initiated immediately to prevent unintended subsequent pregnancies.
How to Approach the Question
- First, identify the key constraints in the question: 'safest method' and 'before 12 weeks' (first trimester).
- Evaluate each option based on its primary medical use and effectiveness within this specific context.
- Eliminate options that are not primary methods of termination. A 'Laminaria tent' is an adjunctive tool for cervical dilation, not a termination method itself.
- Eliminate options that are ineffective for the specified gestational age. 'Oxytocin administration' is not effective in the early first trimester due to a lack of uterine receptors.
- Compare the remaining viable options. 'Dilatation and curettage' is a direct surgical method, while 'Prostaglandin administration' is a medical method. In the first trimester, surgical methods generally have higher efficacy and fewer side effects like prolonged bleeding or incomplete abortion when compared to prostaglandins used alone.
- Conclude that D&C is the safest and most reliable choice among the given options for this scenario.
Concept Tested & Keywords
- Concept Tested: Safest method for first-trimester pregnancy termination
- Stem keywords: safest method, termination of pregnancy, before 12 weeks
- Lead-in keywords: safest
Question ID
Qxmvs_FL_ZOOZSpr3xhQWE
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. 8403-8405
E6 Obstetrics Williams p. 8-20
E6 Pharmacology Katzung 16e p. 527-529
Practise the full IGNOU Post B. SC. Nursing entrance -2021
Attempt every question from this paper in a timed mock, then review the full solution for each one.
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