The surgical widening of the pubic bone to create more space for the baby to pass through is known as:

Appeared in: BTSC Staff Nurse 30July-2025

Explanation

Symphysiotomy is the correct term for the surgical procedure that involves cutting the cartilage of the pubic symphysis.
The primary goal of this procedure is to increase the diameter of the pelvis to facilitate the passage of the baby during obstructed labor.
As depicted in the provided image, the incision is made directly through the pubic symphysis, which is the joint connecting the two pubic bones.
This procedure is an emergency intervention used when other options, like a Cesarean section, are not available or feasible.

Option A: Hysterotomy is an incision into the uterus itself, not the pubic bone. It is a component of a Cesarean section.
Option C: Fasciotomy is a procedure involving an incision into the fascia to relieve pressure, typically in the limbs due to compartment syndrome. It is not related to childbirth or the pelvic bones.
Option D: Episiotomy is a surgical incision made in the perineum (the tissue between the vaginal opening and the anus) to enlarge the vaginal opening. It does not involve the pubic bone.

Clinical Relevance

Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Surgical Procedures in Obstetrics as background academic context rather than a clinical decision trigger.
Symphysiotomy is a life-saving procedure in settings where Cesarean section is not available, but it is associated with significant maternal morbidity, including pelvic girdle pain, instability, urinary incontinence, and difficulty walking.
Nurses must be aware of the potential complications and provide appropriate postoperative care, including pain management, wound care, and assistance with mobility.
What if? If a patient presents with obstructed labor in a well-equipped hospital, a Cesarean section would be the standard of care, not a symphysiotomy, due to the lower risk of long-term maternal complications.

How to Approach the Question

First, carefully read the question to identify the key anatomical structure and the action being performed. The question specifies the 'pubic bone' and 'surgical widening'.
Analyze the provided image. The diagram clearly shows a cut being made through the 'pubic symphysis', which is the joint of the pubic bones.
Evaluate each option based on its medical definition.
Hysterotomy involves the uterus.
Fasciotomy involves muscle fascia.
Episiotomy involves the perineum.

Concept Tested & Keywords

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E6 Obstetrics Williams p. 56-75

E6 Midwifery Obstetrics and Gynecology Nursing Sandeep Kaur p. 24-32

Practise the full BTSC Staff Nurse 30July-2025

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