NORCERT 8 Mains-2025
Obstetrics & Gynaecology
Easy
Which of the following signs of intrauterine death (IUD) is an exception?
Appeared in: NORCERT 8 Mains-2025
Explanation
- Stallworthy's sign is the correct answer as it is a clinical sign related to placenta previa, not intrauterine death (IUD).
- The sign is elicited by pressing the fetal head into the pelvis and observing a temporary drop in the fetal heart rate, which indicates compression of a posteriorly located placenta.
- The presence and monitoring of a fetal heart rate inherently confirm that the fetus is alive, making it an exception to the signs of fetal death.
Why Other Options Were Wrong
- Option A: Maceration is a definitive sign of IUD. It refers to the aseptic softening and peeling of the fetal skin that occurs after the fetus has been dead in the uterus for some time.
- Option B: Robert's sign is a classic radiological sign of IUD. It is the presence of gas bubbles in the fetal heart and great vessels, visible on an X-ray.
- Option D: Spalding's sign is a well-known radiological sign of IUD. It involves the overlapping of the fetal skull bones, which occurs due to the liquefaction and shrinkage of the brain after death.
Related Visual
- Visual 1: Diagram - An illustration showing how Stallworthy's sign is elicited by pressing the fetal head against a posterior placenta.
- Visual 2: X-ray Image - A fetal X-ray demonstrating Spalding's sign, with clear overlapping of the cranial bones.
- Visual 3: X-ray Image - A fetal X-ray showing Robert's sign, with gas shadows visible in the heart and major vessels.
Clinical Relevance
- Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain The question tests the knowledge of differentiating the signs of intrauterine death (IUD) from clinical signs associated with other obstetric conditions as background academic context rather than a clinical decision trigger.
- Accurate identification of the signs of IUD is critical for diagnosis, allowing for timely and sensitive management, including planning for delivery and providing psychosocial support to the grieving parents.
- Distinguishing signs of IUD from signs related to a live fetus (e.g., Stallworthy's sign for placenta previa) is fundamental to avoid catastrophic misdiagnosis and ensure appropriate care is provided.
- A diagnosis of IUD has profound psychological impacts on the parents. Nurses play a vital role in providing compassionate care, facilitating the grieving process, and offering resources for support.
How to Approach the Question
- First, understand the question is asking for an 'exception'. This means you need to find the option that does not fit with the others.
- The central theme is 'signs of intrauterine death (IUD)'. Therefore, three options will be signs of IUD, and one will not.
- Recall or review the definitions of each sign provided in the options.
- Analyze Maceration, Robert's sign, and Spalding's sign. These are all post-mortem changes that occur in a fetus after death.
- Analyze Stallworthy's sign. This sign involves monitoring the fetal heart rate's response to a maneuver. A fetal heart rate can only be monitored in a living fetus.
- Based on this key difference, conclude that Stallworthy's sign is the exception because it indicates a live fetus, whereas the others are signs of a deceased fetus.
Concept Tested & Keywords
- Concept Tested: The question tests the knowledge of differentiating the signs of intrauterine death (IUD) from clinical signs associated with other obstetric conditions.
- Stem keywords: intrauterine death (IUD), signs, exception
- Lead-in keywords: exception
- Negative lead-in flag: The question asks for an exception, meaning the sign that does NOT indicate intrauterine death.
Question ID
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