The placenta failed to separate and deliver. On examination the doctor finds that the placenta has grown through the uterine wall and has attached to the bladder. What kind of abnormal attachments is this called?
Accreta
Plancreta
percreta
increta
The Correct Answer is C
A. Accreta: This refers to the simplest form of morbidly adherent placenta where the chorionic villi attach directly to the myometrium. The placenta does not penetrate the muscle layer but lacks an intervening decidua basalis. It is the most common but least invasive of the three types.
B. Plancreta: This term is not a recognized medical diagnosis in obstetrics or pathology for placental attachment disorders. The standard nomenclature for invasive placentation includes accreta, increta, and percreta based on depth. Using incorrect jargon can lead to clinical errors in surgical planning.
C. percreta: This represents the most severe form of abnormal placentation where villi penetrate through the entire thickness of the myometrium and serosa. The placental tissue can invade adjacent pelvic structures, most commonly the urinary bladder. It carries the highest risk for massive obstetric hemorrhage.
D. increta: In this condition, the placental villi invade deeply into the myometrium but do not breach the outer uterine serosa. While more invasive than accreta, it does not involve the penetration of extrauterine organs like the bladder. It still requires significant surgical management, often a hysterectomy.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
A. adolescents with a breech presentation: Breech presentation in a singleton pregnancy is typically managed via external version or cesarean section. Internal version is an invasive procedure with high risks of uterine rupture and hemorrhage. It is not indicated for routine singleton malpresentations regardless of maternal age.
B. response to fetal distress: Acute fetal distress requires the most rapid and least traumatic delivery method available. Internal version is technically difficult and can worsen fetal trauma or cause placental abruption. It is not an appropriate emergency response for a distressed singleton fetus.
C. multiple gestation, for the birth of the second twin: This maneuver is reserved for delivering a non-vertex second twin after the first twin is born. The clinician reaches into the uterus to pull the fetus into a footling breech for delivery. It is possible due to the dilated cervix.
D. obstetric intensive care unit for delivery of baby in fetal distress: The setting of the delivery does not change the indications for this high-risk maneuver. Internal version is not standard for fetal distress in a singleton pregnancy. It is specifically a tool for managing the delivery of the second twin.
Correct Answer is B
Explanation
A. The relationship of the long axis of the fetus to the long axis of the mother: This definition describes fetal lie, which can be longitudinal, transverse, or oblique. Lie determines the orientation of the fetal spine relative to the maternal spine. It is a separate clinical parameter from the concept of fetal attitude.
B. The relationship of fetal body parts to one another: Attitude refers to the posture of the fetus, typically characterized by flexion or extension of the head and limbs. The normal fetal attitude is general flexion, with the chin on the chest and thighs on the abdomen. This minimizes the presenting diameter.
C. The relationship of the presenting fetal part to the maternal pelvis: This characteristic defines fetal station, which measures the descent of the fetus relative to the ischial spines. Station is measured in centimeters above or below the zero mark. It does not describe the posture or flexion of the fetus.
D. The part of the fetus that enters the pelvis first: This is the definition of fetal presentation, which can be cephalic, breech, or shoulder. Presentation identifies the specific anatomical part that is closest to the internal os. It is independent of the positional relationship between the fetal limbs.
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