IGNOU Post B. SC. Nursing entrance -2021
Obstetrics & Gynaecology
Medium
Which of the following tests should the pregnant woman undergo to confirm normal pregnancy?
Appeared in: IGNOU Post B. SC. Nursing entrance -2021
Explanation
- Ultrasonography is considered a positive sign of pregnancy, providing absolute confirmation.
- It is the only method among the options that can visualize the fetus, confirming its presence, location within the uterus (intrauterine), and viability (fetal heartbeat).
- Transvaginal sonography (TVS) can detect a gestational sac by 4-5 weeks and fetal cardiac motion by 5-6 weeks, making it the definitive test for a 'normal' early pregnancy.
- Confirming a 'normal' pregnancy requires ruling out abnormalities like ectopic or molar pregnancies, which only ultrasonography can do.
Why Other Options Were Wrong
- Option A: A urine hCG test is a probable sign of pregnancy. It detects the presence of the human chorionic gonadotropin hormone but cannot confirm if the pregnancy is viable or correctly located in the uterus.
- Option C: A per-vaginal examination reveals probable signs of pregnancy, such as changes in the cervix (Goodell's sign) and vagina (Chadwick's sign). These signs are suggestive but not definitive, as they can be caused by other conditions.
- Option D: X-ray is contraindicated for pregnancy confirmation due to the harmful effects of radiation on the developing fetus. Although it can visualize the fetal skeleton in late pregnancy (a positive sign), it is never the recommended method for confirmation.
Related Visual
Clinical Relevance
- Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Confirmation of Normal Pregnancy as background academic context rather than a clinical decision trigger.
- Early and accurate confirmation of a normal intrauterine pregnancy via ultrasound is critical for patient safety. It allows for the timely diagnosis and management of ectopic pregnancies, which are a life-threatening emergency.
- Ultrasound provides an accurate estimation of gestational age, which is crucial for scheduling subsequent prenatal care, screening tests, and determining the due date.
- It helps in identifying multiple gestations (twins, triplets) early on, which require specialized management.
How to Approach the Question
- First, analyze the question's keywords: 'confirm' and 'normal pregnancy'. This implies the need for a test that provides definitive, not just suggestive, evidence.
- Recall the three categories of pregnancy signs: presumptive, probable, and positive.
- Evaluate each option based on these categories.
- Urine hCG and PV examination provide probable signs. They suggest pregnancy but cannot rule out abnormalities like an ectopic pregnancy.
- X-ray is a positive sign late in pregnancy but is contraindicated. Therefore, it's not a test one 'should undergo' for confirmation.
- Ultrasonography is a positive sign that can visualize the fetus, its heartbeat, and its location in the uterus. This directly addresses the need to 'confirm' a 'normal' pregnancy.
Concept Tested & Keywords
- Concept Tested: Confirmation of Normal Pregnancy
- Stem keywords: pregnant woman, confirm, normal pregnancy, tests
- Lead-in keywords: Which
- Clinical cues: Age/sex group narrows the expected diagnosis, intervention, or normal reference range.
- Negative lead-in flag: false
Question ID
Qlp8m2MDIbilOP4YHxD3Cw
Reference Book
E6 Midwifery Obstetrics and Gynecology Nursing Sandeep Kaur p. 5-10
E6 Obstetrics Williams p. 71-94
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