Caesarean: Joel-Cohen technique: 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 · Caesarean: Joel-Cohen technique

Sample item

A surgeon performing a Misgav-Ladach caesarean uses a Joel-Cohen skin incision. Which description is correct?

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

The answer and the reasoning

D. A straight transverse incision about 3 cm below the line joining the anterior superior iliac spines, followed by blunt dissection

The Joel-Cohen incision is a straight, transverse skin incision placed higher than the Pfannenstiel, about 3 cm below the line joining the anterior superior iliac spines, with blunt opening of tissue layers by stretching. This approach is faster and has less blood loss, pain and operative time than traditional techniques. The Pfannenstiel is curved, placed 2 to 3 fingerbreadths above the symphysis.

Option by option

  • A. A curved incision 7 cm above the symphysis pubis

    A curved incision describes the Pfannenstiel incision, positioned lower.

  • B. A vertical midline incision below the umbilicus

    A vertical incision is used in emergencies where speed or access matters.

  • C. A paramedian incision with muscle cutting

    A paramedian incision is not used in caesarean section.

  • D. A straight transverse incision about 3 cm below the line joining the anterior superior iliac spines, followed by blunt dissection (correct)

    Correct. This is the straight transverse Joel-Cohen incision with blunt dissection.

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 D, A straight transverse incision about 3 cm below the line joining the anterior superior iliac spines, followed by blunt dissection. The Joel-Cohen incision is a straight, transverse skin incision placed higher than the Pfannenstiel, about 3 cm below the line joining the anterior superior iliac spines, with blunt opening of tissue layers by stretching.

Why is "A curved incision 7 cm above the symphysis pubis" not the answer?

A curved incision describes the Pfannenstiel incision, positioned lower.

Why is "A vertical midline incision below the umbilicus" not the answer?

A vertical incision is used in emergencies where speed or access matters.

Why is "A paramedian incision with muscle cutting" not the answer?

A paramedian incision is not used in caesarean section.

What concept does this question test?

It tests Caesarean: Joel-Cohen technique in OBG. This approach is faster and has less blood loss, pain and operative time than traditional techniques. The Pfannenstiel is curved, placed 2 to 3 fingerbreadths above the symphysis.

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 Caesarean: Joel-Cohen technique?

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.