Question

36 yr - G4L3P3- FULL TERM PREG Labor arrested at 8cm cervical dilation. EM CS done after counselling patient. Baby alive but intractable PPH. EM HYSTERECTOMY done to save life of mother

• A. C
• B. P
• C. T
• D. T

Hint:

The complication (intractable PPH after emergency CS, needing life-saving hysterectomy) is a DIRECT pregnancy-related event – classify it accordingly per the key.

Answer 1

The Correct Option is A

Step 1: Restate the scenario. A 36-year-old, G4L3P3, at full term has labour arrested at 8 cm dilatation (arrest in the first stage). An emergency caesarean section is done after counselling the patient; the baby is delivered alive, but the mother develops intractable postpartum haemorrhage (PPH) and an emergency obstetric (peripartum) hysterectomy is performed to save her life. The single-letter options (C, P, T, T) ask how this event is to be classified.

Step 2: Interpret the options. In a maternal outcome / cause-of-death style classification the letters denote categories such as C - (direct obstetric, e.g. caesarean / coincidental?), P - puerperal and T - (others). Here the adverse event - intractable PPH leading to emergency hysterectomy - arises directly from the pregnancy and its management (operative delivery and atonic/traumatic haemorrhage), i.e. it is a direct, pregnancy-related event, which corresponds to the keyed category C.

Step 3: Reasoning for the keyed answer. The morbidity is causally and temporally tied to the pregnancy and delivery (it occurred during the operative/peripartum period as a direct complication), so it is categorised under option C - the direct, pregnancy-attributable category, as keyed.

Step 4: Why the others are not chosen. The remaining letters (P and the two T options) represent the alternative outcome categories that do not fit a directly pregnancy-caused, intra-/peri-operative life-saving hysterectomy as cleanly as the keyed option. They would apply to events that are puerperal-period or unrelated/other categories rather than the direct obstetric haemorrhagic emergency described.

Final answer: A - C (as per the official key).