Which of the following factors is NOT related to placenta previa?

UPUMS Nsg.Officer-2024

Obstetrics & Gynaecology

Easy

Appeared in: UPUMS Nsg.Officer-2024

Explanation

Placenta previa is a condition where the placenta implants in the lower uterine segment, partially or completely covering the internal cervical os.
Advanced maternal age, typically defined as being older than 35 years, is a well-established risk factor for placenta previa.
The incidence of placenta previa is significantly lower in younger women and increases progressively with maternal age.
Therefore, young age is not a risk factor for placenta previa; it is associated with a lower incidence of the condition.

Option A: This is incorrect because a preceding caesarean section is a major risk factor for placenta previa. Uterine scarring from the surgery can lead to abnormal implantation of the placenta in subsequent pregnancies.
Option B: This is incorrect as having many pregnancies (multiparity or high parity) is a known risk factor that increases the incidence of placenta previa.
Option D: This is incorrect because multiple pregnancy (multifetal gestation) increases the risk of placenta previa. This is thought to be due to the larger placental surface area required or the presence of multiple implantation sites.

Clinical Relevance

Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Risk factors for placenta previa as background academic context rather than a clinical decision trigger.
Identifying patients with risk factors for placenta previa is a crucial nursing responsibility during antenatal care. It allows for early screening, patient education, and appropriate management planning.
Nurses must be aware that any painless vaginal bleeding in the second or third trimester could be placenta previa and should be investigated immediately, especially in high-risk women. Digital vaginal examinations are strictly contraindicated until placenta previa is ruled out by ultrasound.
What if? If a patient with known placenta previa presents with uterine contractions, the nurse's priority is to monitor for bleeding and fetal distress. While tocolytics might be considered in very specific, stable situations to allow for corticosteroid administration, they are often contraindicated due to the risk of masking hemorrhage.

How to Approach the Question

First, understand the question is a 'negative' question, asking for the factor that is NOT related to placenta previa.
Recall the definition of placenta previa: abnormal implantation of the placenta in the lower uterine segment.
Systematically review each option and evaluate if it is a known risk factor for placenta previa.
Option A (caesarean section), Option B (many pregnancies), and Option D (multiple pregnancy) are all well-documented risk factors.
Option C (young age) is the opposite of a known risk factor, which is advanced maternal age (older than 35).
Therefore, 'Young age of the patient' is the factor that is not related to an increased risk of placenta previa, making it the correct answer.

Concept Tested & Keywords

Concept Tested: Risk factors for placenta previa
Stem keywords: placenta previa, factors
Lead-in keywords: NOT related
Negative lead-in flag: Question asks for the factor that is NOT related to the condition.