Which of the following is the natural cervical dilator made from desiccated seaweed?

Appeared in: RUHS, Jaipur, PB B.Sc Nursing Entrance-2019

Explanation

Laminaria tents are derived from the dried stems of a type of seaweed (kelp), specifically Laminaria japonica or Laminaria digitata.
They function as hygroscopic, or osmotic, dilators. When placed in the cervix, they absorb moisture from the surrounding tissues.
This absorption of fluid causes the tent to swell significantly, exerting a slow, gentle, and continuous radial pressure on the cervix.
The process results in gradual and progressive cervical softening and dilation over a period of several hours, typically 12 to 24.

Option A: Prostaglandin E1 (misoprostol) is a synthetic pharmacological agent, not a natural product made from seaweed. It works biochemically to ripen the cervix.
Option B: Prostaglandin E2 (dinoprostone) is also a synthetic hormone used for pharmacological cervical ripening. It is not derived from seaweed and does not work by mechanical swelling.
Option C: Magnesium Sulphate is a medication used as a tocolytic to stop preterm labor and to prevent seizures in pre-eclampsia/eclampsia. It has no role in cervical dilation.

Clinical Relevance

Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Methods of Cervical Ripening and Dilation as background academic context rather than a clinical decision trigger.
Nurses are responsible for patient education regarding what to expect with laminaria placement, including potential cramping, discomfort, and spotting.
Key nursing interventions include monitoring the patient for signs of infection (fever, foul-smelling discharge), excessive pain, or significant vaginal bleeding after insertion.
Nurses must also be aware of contraindications, such as active genital infection or ruptured membranes, where laminaria use could increase the risk of ascending infection.

How to Approach the Question

This is a factual recall question that tests your knowledge of obstetrical procedures and pharmacology.
First, identify the key phrases in the question stem: 'natural', 'cervical dilator', and 'desiccated seaweed'.
Next, evaluate each option based on these keywords.
Options A and B, 'Prostaglandin E1' and 'Prostaglandin E2', are pharmacological agents (hormones), which are synthetic, not natural seaweed products.
Option C, 'Magnesium Sulphate', is a medication known for its use in pre-eclampsia and as a tocolytic, not as a cervical dilator.
Option D, 'Laminaria tents', directly matches the description. 'Laminaria' is a genus of seaweed, and these 'tents' are used for natural, osmotic cervical dilation.

Concept Tested & Keywords

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E6 Gynecology Williams p. 99-127

E6 Obstetrics Williams p. 80-94

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