Self-Assessment Questions (SAQs) for Study Session 20

Now that you have completed this study session, you can assess how well you have achieved its Learning Outcomes by answering the questions that follow. Write your answers in your Study Diary and discuss them with your Tutor at the next Study Support Meeting. You can check your answers with the Notes on the Self-Assessment Questions at the end of this Module.

SAQ 20.1 (tests Learning Outcomes 20.1, 20.3 and 20.5)

Which of the following statements is false? In each case, explain what is incorrect.

A  There is no need to refer all incomplete abortion cases to the next higher health facility.

B  In a complete abortion the tissue inside the uterus has been entirely expelled and the cervix has closed.

C  Women whose abortion is complete will not be able to get pregnant again for some months.

D  After an abortion, a woman should be advised to delay another pregnancy until she has completely recovered.

Answer

A is false. All women with an incomplete abortion should be referred to the next higher health facility. If you leave an incomplete abortion without treatment for some time there is an increased risk that it will be complicated with infection and this could be life-threatening for the woman.

B is true. In a complete abortion the tissue inside the uterus has been entirely expelled and the cervix has closed.

C is false. Women whose abortion is complete can get pregnant again quickly, because fertility returns within two to four weeks.

D is true. After an abortion, a woman should be advised to delay another pregnancy until she has completely recovered.

First read Case Study 20.1 and then answer the questions that follow it.

Case Study 20.1  Mrs X

Mrs X is 26 years old and has been married for 4 years. She has one child who was born 3 years ago and is hoping that she is pregnant again. Mrs X says she has lower abdominal pain and has started bleeding two days ago. When you examine her she has a rapid pulse of 100 beats per minute and blood pressure of 110/60 mmHg. She also has pale conjunctiva and mild lower abdominal tenderness.

SAQ 20.2 (tests Learning Outcomes 20.2 and 20.4)

  • a.What are the possible causes of bleeding at this early stage of her pregnancy?
  • b.What do her other symptoms suggest may be happening?
  • c.Give your reasons to indicate whether it would be safer to refer her to a higher health facility.
  • d.If you refer her, what will you do before referral?

Answer

  • a.The possible causes of bleeding in a woman like Mrs X in the early stage of a pregnancy are:
    • spontaneous abortion (miscarriage)
    • ectopic pregnancy
    • molar pregnancy.
  • b.The fact that she has lower abdominal pain, a rapid pulse of 100 beats/minute, low blood pressure (110/60mmHg), and pale conjunctiva (a sign of anaemia) suggests that she is going into shock due to blood loss.
  • c.She should be referred quickly to a higher health facility because she may lose consciousness and die; she has already been bleeding for two days.
  • d.Before transferring her to the health facility, you should:
    • start an intravenous (IV) fluid infusion to replace the fluids lost through haemorrhage
    • position her in the vehicle with her head flat and her legs raised
    • send someone with her who could act as a blood donor if she needs a transfusion
    • write a clear referral note that covers all essential details.

SAQ 20.3 (tests Learning Outcome 20.5)

Mention three things a good post-abortion family planning service will include.

Answer

You only had to identify three of the following, but a good post-abortion family planning service will include:

  • Counselling about contraceptive needs in terms of the client’s reproductive goals
  • Information and counselling about all available methods, their characteristics, effectiveness and side effects
  • Choices among methods (e.g. short- and long-term, hormonal and non-hormonal)
  • Assurance of contraceptive resupply, so the woman does not run out of protection
  • Access to follow-up care
  • Information about the need for protection against sexually transmitted infections (STIs).

Summary of Study Session 20