Which of the following is a destructive operation whereby the foetal head is severed from the trunk and the delivery is completed?

Appeared in: DSSSB 12 August 2024

Explanation

Decapitation is the specific term for the destructive operation where the fetal head is severed from the trunk.
This procedure is performed to resolve obstructed labor, most commonly in a neglected transverse lie (shoulder presentation) where the fetus is deceased and the neck is accessible.
The delivery is completed in two stages: first the trunk is extracted, and then the decapitated head is delivered separately.

Option A: Cleidotomy involves the division of the fetal clavicle(s) to reduce the diameter of the shoulder girdle.
Option C: Craniochisis is a congenital malformation (a fissure in the skull). The intended term was likely Craniotomy, which is the perforation of the fetal skull to evacuate its contents and reduce its size, not severing the head from the trunk.
Option D: Evisceration involves the removal of thoracic and abdominal organs to reduce the bulk of the fetal trunk.

Clinical Relevance

Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain This question tests knowledge of destructive obstetric operations, which are performed to facilitate delivery in cases of obstructed labor with a deceased fetus as background academic context rather than a clinical decision trigger.
Destructive operations are considered a last resort in modern obstetrics but are crucial, life-saving procedures for the mother in cases of obstructed labor with a confirmed dead fetus, particularly in settings where access to emergency Cesarean section is limited.
The primary goal of these procedures is always maternal survival.
Post-procedure, the nurse must carefully monitor the mother for complications such as uterine rupture, hemorrhage, and puerperal sepsis.

How to Approach the Question

First, carefully read the question and identify the key action described: 'foetal head is severed from the trunk'.
Analyze the options provided. Consider the etymology (origin) of the words if possible.
The term 'Decapitation' literally means 'removal of the head' (from Latin 'de-' meaning removal, and 'caput' meaning head).
This literal meaning directly matches the procedure described in the question stem.
Differentiate this from the other options by recalling their specific actions: Cleidotomy (cutting clavicles), Craniotomy (perforating the cranium), and Evisceration (removing viscera/organs).
Select 'Decapitation' as it is the only term that describes severing the head from the body.

Concept Tested & Keywords

Concept Tested: This question tests knowledge of destructive obstetric operations, which are performed to facilitate delivery in cases of obstructed labor with a deceased fetus.
Stem keywords: destructive operation, foetal head, severed, trunk
Lead-in keywords: Which of the following

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E6 Midwifery Obstetrics and Gynecology Nursing Sandeep Kaur p. 32-40

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