Which instrument is used for low rupture of membranes?

Appeared in: NHM MP Staff Nurse - 2015

Explanation

Kocher's forceps are used for performing an artificial low rupture of membranes (ARM), also known as an amniotomy.
The instrument features toothed tips which allow it to securely grasp and then rupture the amniotic sac to induce or accelerate labor.
It is also utilized for clamping the umbilical cord after delivery.

Option B: Ovum forceps are designed to remove products of conception from the uterus, such as in cases of incomplete abortion.
Option C: Kielland's forceps are a type of obstetric forceps used specifically for rotating the fetal head from a malposition (e.g., occiput posterior or transverse) to facilitate vaginal delivery.
Option D: A curette is a surgical instrument used for scraping or scooping tissue from the lining of the uterus, a procedure known as dilatation and curettage (D&C).

Clinical Relevance

Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Identification and use of obstetric instruments as background academic context rather than a clinical decision trigger.
Knowing the correct instrument for each obstetric procedure is fundamental for patient safety. Using the wrong instrument, such as a traumatic forceps for a delicate procedure, can lead to severe maternal or fetal injury.
The most critical nursing action immediately following an artificial rupture of membranes (amniotomy) is to assess the fetal heart rate (FHR) to rule out umbilical cord prolapse, a serious emergency.
What if? If the FHR drops significantly (bradycardia) immediately after the membranes are ruptured, the nurse should suspect cord prolapse, manually elevate the presenting part off the cord, and prepare for an emergency cesarean section.

How to Approach the Question

This is a factual recall question that tests your knowledge of common obstetric instruments.
First, identify the procedure mentioned in the question: 'low rupture of membranes' (amniotomy).
Next, recall the primary function of each instrument listed in the options.
Kocher's forceps are used for grasping tough tissue and are also used for ARM.
Ovum forceps are for removing products of conception.
Kielland's forceps are for fetal head rotation.

Concept Tested & Keywords

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E6 Midwifery Obstetrics and Gynecology Nursing Sandeep Kaur p. 50-59

E6 Obstetrics Williams p. 39-57

Practise the full NHM MP Staff Nurse - 2015

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