Complications of pregnancy: ovarian cyst: 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 · Complications of pregnancy: ovarian cyst

Sample item

A 22-week pregnant woman has a 9 cm simple unilocular ovarian cyst found incidentally, with no symptoms and normal tumour markers. What is the best approach?

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

The answer and the reasoning

B. Observe with serial ultrasound, as most functional cysts resolve; operate in the second trimester if it persists or becomes symptomatic

Most simple adnexal cysts in pregnancy are benign and resolve by the second trimester. Surgery is indicated for torsion, rupture, suspicion of malignancy or very large size, and the best time is the early second trimester when the miscarriage risk is lowest and the uterus still permits access. Tumour markers such as CA-125 are unreliable in pregnancy.

Option by option

  • A. Immediate termination of pregnancy

    Termination is never indicated for a benign cyst.

  • B. Observe with serial ultrasound, as most functional cysts resolve; operate in the second trimester if it persists or becomes symptomatic (correct)

    Correct. Simple cysts are watched, and surgery is deferred to the second trimester if needed.

  • C. Immediate laparotomy and oophorectomy

    Immediate oophorectomy is excessive for an asymptomatic simple cyst.

  • D. Cyst aspiration under ultrasound in every case

    Aspiration risks recurrence and spillage and is not a routine approach.

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 B, Observe with serial ultrasound, as most functional cysts resolve; operate in the second trimester if it persists or becomes symptomatic. Most simple adnexal cysts in pregnancy are benign and resolve by the second trimester.

Why is "Immediate termination of pregnancy" not the answer?

Termination is never indicated for a benign cyst.

Why is "Immediate laparotomy and oophorectomy" not the answer?

Immediate oophorectomy is excessive for an asymptomatic simple cyst.

Why is "Cyst aspiration under ultrasound in every case" not the answer?

Aspiration risks recurrence and spillage and is not a routine approach.

What concept does this question test?

It tests Complications of pregnancy: ovarian cyst in OBG. Surgery is indicated for torsion, rupture, suspicion of malignancy or very large size, and the best time is the early second trimester when the miscarriage risk is lowest and the uterus still permits access. Tumour markers such as CA-125 are unreliable in pregnancy.

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 Complications of pregnancy: ovarian cyst?

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.