Obstetric emergencies: maternal cardiac arrest: 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 · Obstetric emergencies: maternal cardiac arrest

Sample item

A 32-week pregnant woman collapses with cardiac arrest, and effective CPR with manual left uterine displacement has continued for 4 minutes without return of circulation. What is the next step?

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

The answer and the reasoning

C. Perform a resuscitative (perimortem) caesarean section to be completed by about 5 minutes

Aortocaval compression reduces the effectiveness of chest compressions in late pregnancy, and emptying the uterus can restore venous return and cardiac output. A resuscitative hysterotomy should begin by 4 minutes with delivery by about 5 minutes if there is no return of circulation, at about 20 weeks or beyond for maternal benefit, and it is done at the scene without transfer. Delay worsens maternal and fetal outcome.

Option by option

  • A. Administer tocolytics

    Tocolytics would not help in cardiac arrest.

  • B. Continue CPR for another 20 minutes before considering delivery

    Prolonged CPR without delivery worsens maternal outcome.

  • C. Perform a resuscitative (perimortem) caesarean section to be completed by about 5 minutes (correct)

    Correct. Delivery within about 5 minutes of arrest improves maternal resuscitation.

  • D. Transfer to the operating theatre before any intervention

    Transfer wastes time and the procedure is done where she arrested.

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, Perform a resuscitative (perimortem) caesarean section to be completed by about 5 minutes. Aortocaval compression reduces the effectiveness of chest compressions in late pregnancy, and emptying the uterus can restore venous return and cardiac output.

Why is "Administer tocolytics" not the answer?

Tocolytics would not help in cardiac arrest.

Why is "Continue CPR for another 20 minutes before considering delivery" not the answer?

Prolonged CPR without delivery worsens maternal outcome.

Why is "Transfer to the operating theatre before any intervention" not the answer?

Transfer wastes time and the procedure is done where she arrested.

What concept does this question test?

It tests Obstetric emergencies: maternal cardiac arrest in OBG. A resuscitative hysterotomy should begin by 4 minutes with delivery by about 5 minutes if there is no return of circulation, at about 20 weeks or beyond for maternal benefit, and it is done at the scene without transfer. Delay worsens maternal and fetal outcome.

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 Obstetric emergencies: maternal cardiac arrest?

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.