Early pregnancy: surgical evacuation method: practice question

A OBG question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

Try it

OBG · Early pregnancy: surgical evacuation method

Sample item

A 24-year-old with a confirmed missed miscarriage at 9 weeks who is haemodynamically stable chooses surgical management. Which method is generally preferred in the first trimester?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

A. Manual or electric vacuum aspiration

Vacuum aspiration, manual (MVA) or electric, is the preferred surgical method up to about 12 weeks because it has lower rates of blood loss, perforation and incomplete evacuation than sharp curettage. It can be done as an outpatient with paracervical block. Medical management with misoprostol is an alternative.

Option by option

  • A. Manual or electric vacuum aspiration (correct)

    Correct. Vacuum aspiration is the safest surgical method in the first trimester.

  • B. Intra-amniotic hypertonic saline

    Hypertonic saline instillation is obsolete.

  • C. Sharp curettage under general anaesthesia

    Sharp curettage is less safe and is not preferred where aspiration is available.

  • D. Hysterotomy

    Hysterotomy is reserved for rare second-trimester situations.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

More OBG questions

Questions about this OBG question

What is the answer to this OBG question?

The best answer is A, Manual or electric vacuum aspiration. Vacuum aspiration, manual (MVA) or electric, is the preferred surgical method up to about 12 weeks because it has lower rates of blood loss, perforation and incomplete evacuation than sharp curettage.

Why is "Intra-amniotic hypertonic saline" not the answer?

Hypertonic saline instillation is obsolete.

Why is "Sharp curettage under general anaesthesia" not the answer?

Sharp curettage is less safe and is not preferred where aspiration is available.

Why is "Hysterotomy" not the answer?

Hysterotomy is reserved for rare second-trimester situations.

What concept does this question test?

It tests Early pregnancy: surgical evacuation method in OBG. It can be done as an outpatient with paracervical block. Medical management with misoprostol is an alternative.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Early pregnancy: surgical evacuation method?

Learn management algorithms as steps: PPH, eclampsia, ectopic pregnancy. Then use the flashcards and the other OBG questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.