Withdrawal of fluid from uterus through abdominal wall

KGMU 2024

Obstetrics & Gynaecology

Easy

Appeared in: KGMU 2024

Explanation

Amniocentesis is a prenatal diagnostic procedure that involves withdrawing amniotic fluid from the uterine cavity.
The procedure is performed by inserting a long, thin needle through the maternal abdominal wall and uterine wall into the amniotic sac, typically under ultrasound guidance.
The fluid contains fetal cells and biochemical substances used for genetic testing, assessing fetal lung maturity, and detecting infections.
This procedure directly matches the description in the question stem.

Option A: Culdoscopy is an endoscopic procedure for visualizing pelvic organs, but the entry point is through the posterior vaginal fornix, not the abdominal wall.
Option B: Laparoscopy involves making incisions in the abdominal wall to insert a camera and instruments for viewing or operating on abdominal and pelvic organs. Its primary purpose is not the withdrawal of fluid from the uterus.
Option D: A partograph is a graphical chart, a documentation tool used to monitor the progress of labor over time. It is not a procedure for fluid withdrawal.

Visual 1: Diagram - An illustration of the amniocentesis procedure, showing a needle passing through the maternal abdominal wall, uterine wall, and into the amniotic sac to aspirate fluid, with ultrasound guidance.
Visual 2: Chart - An image of a WHO partograph to visually differentiate a monitoring tool from an invasive procedure.

Clinical Relevance

Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Antenatal Diagnostic Procedures as background academic context rather than a clinical decision trigger.
The nurse's role is critical in preparing the patient for amniocentesis by explaining the procedure, ensuring informed consent is obtained, and instructing the patient to empty her bladder.
During and after the procedure, the nurse must monitor maternal vital signs and the fetal heart rate for any signs of distress, bleeding, infection, or preterm labor.
Patient education is key. The nurse should instruct the patient to report any cramping, vaginal bleeding, or leakage of fluid after returning home.

How to Approach the Question

First, break down the question stem into its key components: 1) 'Withdrawal of fluid', 2) from the 'uterus', 3) through the 'abdominal wall'.
Next, evaluate each option based on these three components.
Analyze 'Culdoscopy': This is a vaginal approach, so it doesn't match 'through the abdominal wall'. Eliminate this option.
Analyze 'Laparoscopy': This is an abdominal approach, but its primary purpose is visualization/surgery, not fluid withdrawal from the uterus. It's a less precise match.
Analyze 'Partograph': This is a chart for monitoring labor, not a procedure for fluid withdrawal. Eliminate this option.
Analyze 'Amniocentesis': This procedure's definition is the withdrawal of amniotic fluid from the uterus via a needle through the abdominal wall. This perfectly matches all key components of the question.

Concept Tested & Keywords

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