Contraception: pregnancy with IUCD in situ: 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 · Contraception: pregnancy with IUCD in situ

Sample item

A woman with a copper IUCD in situ has a positive pregnancy test at 7 weeks with an intrauterine sac on ultrasound. The threads are visible at the cervix. What is the best management?

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

The answer and the reasoning

D. Remove the device gently now after counselling, as it reduces miscarriage and infection risk

Continuing pregnancy with an IUCD in place carries higher risks of miscarriage, septic abortion, preterm birth and chorioamnionitis. When the threads are visible, early removal reduces these risks, although some miscarriage risk remains. If the threads are not visible and the woman continues the pregnancy, she needs close surveillance.

Option by option

  • A. Perform a cerclage

    Cerclage does not address the device.

  • B. Advise immediate termination in all cases

    Termination is a choice and not mandatory.

  • C. Leave the device in place until delivery

    Leaving it increases the risk of septic miscarriage.

  • D. Remove the device gently now after counselling, as it reduces miscarriage and infection risk (correct)

    Correct. Early removal of the device with visible threads lowers complications.

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, Remove the device gently now after counselling, as it reduces miscarriage and infection risk. Continuing pregnancy with an IUCD in place carries higher risks of miscarriage, septic abortion, preterm birth and chorioamnionitis.

Why is "Perform a cerclage" not the answer?

Cerclage does not address the device.

Why is "Advise immediate termination in all cases" not the answer?

Termination is a choice and not mandatory.

Why is "Leave the device in place until delivery" not the answer?

Leaving it increases the risk of septic miscarriage.

What concept does this question test?

It tests Contraception: pregnancy with IUCD in situ in OBG. When the threads are visible, early removal reduces these risks, although some miscarriage risk remains. If the threads are not visible and the woman continues the pregnancy, she needs close surveillance.

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 Contraception: pregnancy with IUCD in situ?

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.