Which of the following results in scalp injury during the intra-partum period?

UPUMS Nsg officer-2023

Obstetrics & Gynaecology

Easy

Appeared in: UPUMS Nsg officer-2023

Explanation

The question asks to identify the procedure that causes scalp injury during the intra-partum (during labor) period.
Collection of fetal scalp blood is an invasive diagnostic test performed during labor to assess for fetal acidosis when there are concerns about fetal well-being (e.g., non-reassuring fetal heart rate patterns).
The procedure involves making a small incision on the fetal scalp with a special blade to obtain a capillary blood sample.
This deliberate incision is a direct cause of a minor scalp injury, making it the correct answer.

Option A: Amniocentesis and cordocentesis are performed during the antepartum (before labor) period, not the intra-partum period. Amniocentesis involves aspirating amniotic fluid, and cordocentesis involves taking a blood sample from the umbilical cord. Neither procedure targets the fetal scalp.
Option B: Multiple gestations refers to being pregnant with more than one fetus (e.g., twins, triplets). It is a condition of pregnancy, not a procedure, and does not inherently cause scalp injury.
Option C: Chorionic villus sampling (CVS) is an antepartum procedure, typically performed early in pregnancy (10-13 weeks), to obtain a sample of placental tissue for genetic analysis. It does not involve the fetus directly and does not cause scalp injury.

Clinical Relevance

Nursing practice connection: Knowing Fetal assessment procedures and associated risks during the intra-partum period helps nurses interpret findings accurately and avoid errors in routine assessment, medication administration, and patient teaching.
Fetal scalp blood sampling is a critical tool for clarifying a non-reassuring fetal heart rate tracing, helping to distinguish between a fetus that is compensating and one that is developing metabolic acidosis and requires immediate delivery.
Nurses play a key role in preparing the patient, assisting with the procedure, monitoring the fetal heart rate before, during, and after sampling, and applying pressure to the puncture site to ensure hemostasis.
Patient safety involves ensuring that prerequisites are met (e.g., ruptured membranes, sufficient cervical dilation) and being prepared for an emergency cesarean delivery if the results indicate severe fetal distress.

How to Approach the Question

First, break down the question into its key components: the action is 'results in scalp injury' and the timing is 'during the intra-partum period' (during labor).
Evaluate each option based on these two criteria.
Option A: Amniocentesis and cordocentesis are antepartum procedures and do not involve the scalp. Eliminate.
Option B: Multiple gestations is a condition, not a procedure that causes injury. Eliminate.
Option C: Chorionic villus sampling is an antepartum procedure that samples the placenta, not the scalp. Eliminate.
Option D: Collection of fetal scalp blood is, by its name, a procedure involving the fetal scalp. It is performed intra-partum to assess for fetal distress. This procedure requires making a small cut (injury) to obtain blood. This option matches both criteria perfectly.

Concept Tested & Keywords

Concept Tested: Fetal assessment procedures and associated risks during the intra-partum period.
Stem keywords: scalp injury, intra-partum period
Lead-in keywords: Which

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E6 Obstetrics Williams p. 37-56

E6 Midwifery Obstetrics and Gynecology Nursing Sandeep Kaur p. 52-63