Postpartum haemorrhage: hysterectomy 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 · Postpartum haemorrhage: hysterectomy technique

Sample item

A woman with refractory atonic PPH, unresponsive to drugs, balloon tamponade and compression sutures, becomes unstable and needs a life-saving hysterectomy. What is an acceptable approach?

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

The answer and the reasoning

C. Subtotal hysterectomy, as it is quicker with similar outcomes in this emergency

In an unstable woman, subtotal (supracervical) hysterectomy is faster, has less blood loss and fewer urinary tract injuries and is accepted for atony. Total hysterectomy is needed when bleeding arises from the lower segment or cervix, such as in placenta praevia or accreta low in the segment, or from a cervical tear. Early decision-making reduces mortality.

Option by option

  • A. Vaginal hysterectomy

    Vaginal hysterectomy is impractical in a postpartum enlarged uterus.

  • B. Hysterectomy only after waiting 6 hours

    Delay increases blood loss and mortality.

  • C. Subtotal hysterectomy, as it is quicker with similar outcomes in this emergency (correct)

    Correct. A subtotal hysterectomy is a quick and acceptable life-saving operation for atony.

  • D. Radical hysterectomy with lymphadenectomy

    Radical hysterectomy is for cancer and has more morbidity.

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 C, Subtotal hysterectomy, as it is quicker with similar outcomes in this emergency. In an unstable woman, subtotal (supracervical) hysterectomy is faster, has less blood loss and fewer urinary tract injuries and is accepted for atony.

Why is "Vaginal hysterectomy" not the answer?

Vaginal hysterectomy is impractical in a postpartum enlarged uterus.

Why is "Hysterectomy only after waiting 6 hours" not the answer?

Delay increases blood loss and mortality.

Why is "Radical hysterectomy with lymphadenectomy" not the answer?

Radical hysterectomy is for cancer and has more morbidity.

What concept does this question test?

It tests Postpartum haemorrhage: hysterectomy technique in OBG. Total hysterectomy is needed when bleeding arises from the lower segment or cervix, such as in placenta praevia or accreta low in the segment, or from a cervical tear. Early decision-making reduces mortality.

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 Postpartum haemorrhage: hysterectomy 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.