Early pregnancy: tubal surgery: 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 · Early pregnancy: tubal surgery

Sample item

A 28-year-old with an unruptured left ampullary ectopic is haemodynamically stable. Her right tube is blocked from previous pelvic infection, and she wishes future fertility. Which operation is preferred?

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

The answer and the reasoning

C. Laparoscopic salpingostomy with hCG follow-up

When the contralateral tube is diseased and the woman desires fertility, salpingostomy conserves the affected tube, although persistent trophoblast occurs in a few percent and needs weekly hCG follow-up with methotrexate if levels plateau. If the contralateral tube is healthy, salpingectomy is preferred. Hysterectomy is not indicated.

Option by option

  • A. Total abdominal hysterectomy

    Hysterectomy is not indicated for a stable ectopic.

  • B. Laparoscopic salpingectomy of the left tube

    Salpingectomy would leave her with no functioning tube, which is less suitable here.

  • C. Laparoscopic salpingostomy with hCG follow-up (correct)

    Correct. Salpingostomy preserves the only potentially functional tube.

  • D. Bilateral salpingectomy

    Removing both tubes would make her sterile without IVF.

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 C, Laparoscopic salpingostomy with hCG follow-up. When the contralateral tube is diseased and the woman desires fertility, salpingostomy conserves the affected tube, although persistent trophoblast occurs in a few percent and needs weekly hCG follow-up with methotrexate if levels plateau.

Why is "Total abdominal hysterectomy" not the answer?

Hysterectomy is not indicated for a stable ectopic.

Why is "Laparoscopic salpingectomy of the left tube" not the answer?

Salpingectomy would leave her with no functioning tube, which is less suitable here.

Why is "Bilateral salpingectomy" not the answer?

Removing both tubes would make her sterile without IVF.

What concept does this question test?

It tests Early pregnancy: tubal surgery in OBG. If the contralateral tube is healthy, salpingectomy is preferred. Hysterectomy is not indicated.

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 Early pregnancy: tubal surgery?

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.