PMC Contraindications & Risk Factors 2 — Questions and Answers
Question 1: A client at 28 weeks presents with sudden severe headache, visual disturbances, and swollen hands. Which condition does this suggest, and what should the therapist do?
- Proceed with a gentle relaxation massage
- Refer immediately to her healthcare provider and do not massage (Correct answer)
- Elevate her legs and continue with light effleurage
- Apply cold compresses and continue the session
Correct answer: Refer immediately to her healthcare provider and do not massage
Sudden severe headache, visual changes, and rapid edema are warning signs of preeclampsia, an absolute contraindication requiring immediate medical referral.
Question 2: Placenta previa is a contraindication primarily because prenatal massage could:
- Cause uterine contractions leading to placental separation and hemorrhage (Correct answer)
- Increase maternal blood pressure beyond safe limits
- Compress the sciatic nerve causing permanent damage
- Reduce amniotic fluid levels below normal range
Correct answer: Cause uterine contractions leading to placental separation and hemorrhage
In placenta previa the placenta covers the cervical os, and stimulating uterine contractions through massage risks placental abruption and life-threatening bleeding.
Question 3: A client discloses she has been diagnosed with gestational diabetes mellitus (GDM). How should this affect the massage plan?
- GDM is an absolute contraindication; cancel the session
- Work within normal prenatal guidelines but monitor for neuropathy and circulation changes (Correct answer)
- Avoid all Swedish techniques and use only reflexology
- Restrict sessions to the first trimester only
Correct answer: Work within normal prenatal guidelines but monitor for neuropathy and circulation changes
GDM is a relative consideration rather than an absolute contraindication; the therapist should adapt by checking for peripheral neuropathy and circulatory complications.
Question 4: Which of the following describes an absolute contraindication for prenatal massage?
- Mild lower back discomfort at 20 weeks
- Active vaginal bleeding of unknown origin (Correct answer)
- Moderate wrist carpal tunnel syndrome
- First-trimester morning nausea with no complications
Correct answer: Active vaginal bleeding of unknown origin
Active vaginal bleeding of unknown origin is an absolute contraindication because massage could worsen the underlying cause and endanger mother and fetus.
Question 5: A therapist notices significant pitting edema in one leg only of a third-trimester client. The appropriate response is to:
- Massage that leg vigorously to stimulate lymphatic drainage
- Treat both legs equally and document the finding
- Avoid massaging that leg and refer for deep vein thrombosis evaluation (Correct answer)
- Apply heat to reduce the swelling before proceeding
Correct answer: Avoid massaging that leg and refer for deep vein thrombosis evaluation
Unilateral pitting edema is a DVT red flag; massaging an active clot could dislodge it and cause a pulmonary embolism.
Question 6: Cervical incompetence (insufficiency) in a current pregnancy is considered:
- A minor relative contraindication manageable with positioning changes
- An absolute contraindication because stimulation may induce early labor (Correct answer)
- Only relevant during the first trimester
- A condition that clears up after 24 weeks and poses no further risk
Correct answer: An absolute contraindication because stimulation may induce early labor
Cervical incompetence means the cervix cannot hold the pregnancy to term, making any massage that stimulates uterine contractions potentially catastrophic.
Question 7: When a prenatal massage client has a history of recurrent miscarriages, the safest approach during the first trimester is to:
- Perform deep tissue work only on the back to avoid the abdomen
- Obtain written medical clearance before performing any massage (Correct answer)
- Limit sessions to 30 minutes but use standard protocols otherwise
- Focus exclusively on reflexology points associated with relaxation
Correct answer: Obtain written medical clearance before performing any massage
A history of recurrent miscarriages places the client in a higher-risk category; written medical clearance ensures the provider agrees massage is appropriate at this stage.
PMC Contraindications & Risk Factors 2
A client at 28 weeks presents with sudden severe headache, visual disturbances, and swollen hands.
Which condition does this suggest, and what should the therapist do?