Preterm labour: short cervix: 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.

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OBG · Preterm labour: short cervix

Sample item

A woman with a singleton pregnancy and no previous preterm birth has a transvaginal cervical length of 14 mm at the routine 20-week anomaly scan. What is the best management?

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

The answer and the reasoning

A. Daily vaginal micronised progesterone 200 mg until 36 weeks

A cervical length of 25 mm or less in the mid-trimester identifies high risk, and vaginal progesterone reduces preterm birth in such women with a singleton pregnancy. Cerclage is considered with a prior preterm birth or if the cervix is very short with such a history. Bed rest has no proven benefit.

Option by option

  • A. Daily vaginal micronised progesterone 200 mg until 36 weeks (correct)

    Correct. Vaginal progesterone is first-line for an asymptomatic short cervix in a singleton gestation.

  • B. Routine bed rest at home

    Bed rest is not effective.

  • C. Elective delivery at 34 weeks

    Elective early delivery is not indicated.

  • D. Immediate tocolysis with nifedipine

    Tocolysis is for symptomatic preterm labour, not an asymptomatic short cervix.

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.

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Questions about this OBG question

What is the answer to this OBG question?

The best answer is A, Daily vaginal micronised progesterone 200 mg until 36 weeks. A cervical length of 25 mm or less in the mid-trimester identifies high risk, and vaginal progesterone reduces preterm birth in such women with a singleton pregnancy.

Why is "Routine bed rest at home" not the answer?

Bed rest is not effective.

Why is "Elective delivery at 34 weeks" not the answer?

Elective early delivery is not indicated.

Why is "Immediate tocolysis with nifedipine" not the answer?

Tocolysis is for symptomatic preterm labour, not an asymptomatic short cervix.

What concept does this question test?

It tests Preterm labour: short cervix in OBG. Cerclage is considered with a prior preterm birth or if the cervix is very short with such a history. Bed rest has no proven benefit.

How hard is this question?

We tag it as a multi-step question: it asks you to combine more than one idea. 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 Preterm labour: short cervix?

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.