The second stage of labor ends with?

Appeared in: DSSSB - 29 August 2019 (Shift-1)

Explanation

The second stage of labor is defined as the period from full cervical dilatation (10 cm) until the complete expulsion of the fetus.
This stage is often called the 'expulsive stage' because its primary event is the mother pushing the baby out.
The culmination and definitive end of this stage is the birth of the newborn.
The subsequent stage, the third stage, begins immediately after the baby is born.

Option A: A change in uterine shape from discoid to globular is a sign of placental separation.
Option B: A sudden gush of dark blood is also a sign of placental separation.
Option D: Strong uterine contractions are the mechanism that drives labor, but they do not define the end of a stage.

Clinical Relevance

Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain The question tests the knowledge of the specific events that define the end of the second stage of labor as background academic context rather than a clinical decision trigger.
Nurses must accurately identify the stage of labor to provide appropriate care, such as coaching pushing efforts during the second stage and preparing for placental delivery in the third stage.
Recognizing the transition from the second to the third stage is critical for initiating active management of the third stage (AMTSL) to prevent postpartum hemorrhage (PPH).
Monitoring for signs of placental separation (like a gush of blood or change in uterine shape) alerts the nurse that the third stage is progressing.

How to Approach the Question

First, identify the core concept being tested, which is the definition of the stages of labor.
Recall the specific start and end points for each of the four stages.
Focus on the second stage. Remember this is the 'pushing' or 'expulsive' stage.
Analyze the options. Option C, 'The birth of the new-born,' directly corresponds to the definition of the end of the second stage.
Evaluate the other options. Recognize that a change in uterine shape and a gush of blood are signs of placental separation, which defines the third stage.
Eliminate 'strong uterine contractions' as it's a process that occurs throughout labor, not a concluding event of a specific stage.

Concept Tested & Keywords

Concept Tested: The question tests the knowledge of the specific events that define the end of the second stage of labor.
Stem keywords: second stage of labor, ends with
Lead-in keywords: BEST, MOST RELEVANT CLUE

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E6 Physiology Guyton 4SAE Part 3 p. 67-69

E6 Midwifery Obstetrics and Gynecology Nursing Sandeep Kaur p. 40-48

Practise the full DSSSB - 29 August 2019 (Shift-1)

Attempt every question from this paper in a timed mock, then review the full solution for each one.